Russian Heart Failure Journal 2011year D-dimer as a marker of chronic heart failure decompensation

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D-dimer as a marker of chronic heart failure decompensation

Vorobjeva N. M., Dobrovolskiy A. B., Titaeva E. V., Panchenko E. P.
Federal State Budgetary Institution, “Russian Cardiology Research and Production Complex” of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: D-dimer, cardiac decompensation, CHF

DOI: 10.18087/rhfj.2011.1.1465

Background. CHF is a procoagulant state and is accompanied by increased plasma level of several components of hemostatic system, including D-dimer. Objective. To study the diagnostic role of quantitative determination of D-dimer as a marker of decompensated heart failure. Materials and methods. This retrospective analysis included 279 patients with CHF. The level of D-dimer was measured in all patients during hospitalization. Thromboembolic complications were verified or rejected through a complex instrumental and laboratory methods. Results. The level of D-dimer exceeded the upper limit of normal distribution in 146 (52 %) patients with CHF. The rate of decompensated heart failure was 27 %. Correlation analysis revealed a direct correlation between D-dimer level and age, female sex, thromboembolic complications, decompensated heart failure, CHF FC, pulmonary artery systolic pressure and indirect correlation between D-dimer level and LVEF. The analysis excluded patients with thromboembolic complications in determining the diagnostic role of D-dimer. 21 % out of 57 patients with decompensated CHF had normal D-dimer level and 79 % – higher level. Out of 173 patients with compensated CHF D-dimer level was normal in 65 % and exceeded the norm in 35 %. These data allowed us to consider D-dimer as a possible new marker of decompensated heart failure with sensitivity of 79 % and specificity of 65 %.
  1. Агеев Ф. Т., Даниелян М. О., Мареев В. Ю., Беленков Ю. Н. Больные с хронической сердечной недостаточностью в российской амбулаторной практике: особенности контингента, диагностики и лечения  (по материалам исследования ЭПОХА–О–ХСН). Журнал Сердечная Недостаточность. 2004;5 (1):4–7.
  2. Cleland JG, Swedberg K, Follath F et al. The EuroHeart Failure survey programme a survey on the quality of care among patients with heart failure in Europe. Part 1: patients characteristics and diagnosis. Eur Heart J. 2003;24 (5):442–463.
  3. Marcucci R, Gori AM, Giannotti F et al. Markers of hypercoagulability and inflammation predict mortality in patients with heart failure. J Thromb Haemost. 2006;4:1017–1022.
  4. Jug B, Vene N, Salobir BG et al. Procoagulant state in heart failure with preserved left ventricular ejection fraction. Int Heart J. 2009;50: 591–600.
  5. Cugno M, Mari D, Meroni PL et al. Haemostatic and inflammatory biomarkers in advanced chronic heart failure: role of oral anticoagulants and successful heart transplantation. Br J Haemotol. 2004;126:85–92.
  6. Raimondi P, Bongard O, de Moerloose P et al. D-dimer plasma concentration in various clinical conditions: implication for the use of this test in the diagnostic approach of venous thromboembolism. Thromb Res. 1993;69:125–130.
  7. Панченко Е. П., Добровольский А. Б. Тромбозы в кардиологии. Механизмы развития и возможности терапии. – М.: Спорт и культура, 1999. – 464 с.
  8. Vorobyeva NM, Dobrovolsky AB, Titaeva EV, Panchenko EP. Independent predictors of elevated D-dimer level in patients with chronic heart failure. Eur J Heart Fail. 2010;9 (Suppl 1):S205.
  9. Воробьева Н. М., Панченко Е. П., Добровольский А. Б. и др. Повышение Д-димера у больных сердечно-сосудистыми заболеваниями без тромбоэмболических осложнений: с чем связано и что с этим делать? Ангиология и сосудистая хирургия. 2010;16 (4):31–39.
  10. Мареев В. Ю., Агеев Ф. Т., Арутюнов Г. П. и др. Национальные рекомендации ВНОК и ОССН по диагностике и лечению ХСН (третий пересмотр). Журнал Сердечная Недостаточность. 2010;11 (1):3–62.
  11. Dickstein K, Cohen-Solal A, Filippatos G et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM). Eur Heart J. 2008;29 (19):2388–2442.
  12. Hobbs FDR, Davis RC, Roalfe AK et al. Reliability of N-terminal pro-brain natriuretic peptide assay in diagnosis of heart failure: cohort study in representative and high risk community populations. BMJ. 2002;324 (7352):1498.
  13. Maisel AS, Krishnaswamy P, Nowak RM et al. Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure. N Engl J Med. 2002;347 (3):161–167.
  14. Jourdain P, Jondeau G, Funck F et al. Plasma brain natriuretic peptide-guided therapy to improve outcome in heart failure: the STARS-BNP Multicenter Study. J Am Coll Cardiol. 2007;49 (16):1733–1739.
  15. Metra M, Nodari S, Parrinello G et al. The role of plasma biomarkers in acute heart failure. Serial changes and independent prognostic value of NT-proBNP and cardiac troponin-T. Eur J Heart Fail. 2007;9 (8):776–786.
  16. Troughton RW, Frampton CM, Yandle TG et al. Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations. Lancet. 2000;355 (9210):1126–1130.
  17. Sukova J, Ostadal P, Widimsky P. Profile of patients with acute heart failure and elevated troponin I levels. Exp Clin Cardiol. 2007;12 (3):153–156.
  18. Del Carlo CH, Pereira-Barretto AC, Cassaro-Strunz CM et al. Cardiac Troponin T for Risk Stratification in Decompensated Chronic Heart Failure. Arq Bras Cardiol. 2009;92 (5):372–380.
  19. Maisel AS, Bhalla V, Braunwald E. Cardiac biomarkers: a contemporary status report. Nat Clin Pract Cardiovasc Med. 2006;3 (1):24–34.
  20. Jug B, Vene N, Salobir BG et al. Prognostic impact of haemostatic derangements in chronic heart failure. Thromb Haemost. 2009;102 (2):185–187.
  21. Zairis MN, Tsiaousis GZ, Georgilas AT et al. Multimarker strategy for the prediction of 31 days cardiac death in patients with acutely decompensated chronic heart failure. Int J Cardiol. 2010;141 (3):284–290.
  22. Raymond I, Groenning BA, Hildebrandt PR et al. The influence of age, sex and other variables on the plasma level of N-terminal pro brain natriuretic peptide in a large sample of the general population. Heart. 2003;89 (7):745–751.
  23. Panchenko E, Dobrovolsky A, Davletov K. D-dimer and fibrinolysis in patients with various degrees of atherosclerosis. Eur Heart J. 1995;16 (1):38–42.
  24. Tita-Nwa F, Bos A, Adjei A et al. Correlates of D-dimer in older persons. Aging Clin Exp Res. 2010;22 (1):20–23.
  25. Shitrit D, Bendayan D, Bar-Gil-Shitrit A et al. Significance of a plasma D-dimer test in patients with primary pulmonary hypertension. Chest. 2002;122 (5):1674–1678.
  26. Ergün K, Balbay Y, Cihan G et al. Thrombotic, fibrinolytic and proliferative activities of pulmonary vascular bed in secondary pulmonary hypertension. Anadolu Kardiyol Derg. 2005;5 (2):95–100.
Vorobjeva N.M., Dobrovolskiy A.B., Titaeva E.V. et al. D-dimer as a marker of chronic heart failure decompensation. Russian Heart Failure Journal. 2011;12(1):36-41.

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