Patients with heart failure possess coagulation disorders and a risk of thromboembolic events in the vascular system. This risk could potentially be derived from many sources such as inflammation, neuro-hormonal activation, endothelial dysfunction, and stasis [
- Lip G.Y.
- Gibbs C.R.
Does heart failure confer a hypercoagulable state? Virchow's triad revisited.
J Am Coll Cardiol. 1999; 33: 1424-1426
2]. D-dimer, a marker of fibrin turnover, is elevated where there is thrombus formation and/or resolution in the circulatory system, and exhibits many interesting properties as a biological marker of hemostatic abnormalities and thrombosis [
- Zannad F.
- Stough W.G.
- Regnault V.
- et al.
Is thrombosis a contributor to heart failure pathophysiology? Possible mechanisms, therapeutic opportunities, and clinical investigation challenges.
Int J Cardiol. 2013; 167: 1772-1782
]. Previous studies have shown that elevated D-dimer levels are present in patients with cardiovascular disease [
- Koracevic G.P.
Pragmatic classification of the causes of high D-dimer.
Am. J. Emerg. Med. 2009; 27 (e5–7): 1016
- Yamamoto K.
- Ikeda U.
- Furuhashi K.
- Irokawa M.
- Nakayama T.
- Shimada K.
The coagulation system is activated in idiopathic cardiomyopathy.
J Am Coll Cardiol. 1995; 25: 1634-1640
5], and several studies have suggested that elevated D-dimer levels are associated with long-term adverse outcomes in patients with established chronic and/or systolic heart failure [
- Morange P.E.
- Bickel C.
- Nicaud V.
- et al.
Haemostatic factors and the risk of cardiovascular death in patients with coronary artery disease: the AtheroGene study.
Arterioscler Thromb Vasc Biol. 2006; 26: 2793-2799
- Alehagen U.
- Dahlstrom U.
- Lindahl T.L.
Elevated D-dimer level is an independent risk factor for cardiovascular death in out-patients with symptoms compatible with heart failure.
Thromb Haemost. 2004; 92: 1250-1258
7]. However, the short- and medium-term prognostic value of D-dimer levels on admission in hospitalized patients with acute decompensated heart failure (ADHF) is not well established. Therefore, this study aimed to analyze the in-hospital and medium-term prognostic value of elevated D-dimer levels in patients who were admitted to a cardiac intensive care unit with ADHF.
- Zorlu A.
- Yilmaz M.B.
- Yucel H.
- Bektasoglu G.
- Refiker Ege M.
- Tandogan I.
Increased D-dimer levels predict cardiovascular mortality in patients with systolic heart failure.
J Thromb Thrombolysis. 2012; 33: 322-328
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- Does heart failure confer a hypercoagulable state? Virchow's triad revisited.J Am Coll Cardiol. 1999; 33: 1424-1426
- Is thrombosis a contributor to heart failure pathophysiology? Possible mechanisms, therapeutic opportunities, and clinical investigation challenges.Int J Cardiol. 2013; 167: 1772-1782
- Pragmatic classification of the causes of high D-dimer.Am. J. Emerg. Med. 2009; 27 (e5–7): 1016
- The coagulation system is activated in idiopathic cardiomyopathy.J Am Coll Cardiol. 1995; 25: 1634-1640
- Haemostatic factors and the risk of cardiovascular death in patients with coronary artery disease: the AtheroGene study.Arterioscler Thromb Vasc Biol. 2006; 26: 2793-2799
- Elevated D-dimer level is an independent risk factor for cardiovascular death in out-patients with symptoms compatible with heart failure.Thromb Haemost. 2004; 92: 1250-1258
- Increased D-dimer levels predict cardiovascular mortality in patients with systolic heart failure.J Thromb Thrombolysis. 2012; 33: 322-328
- Hypercoagulability in heart failure.Semin Thromb Hemost. 1997; 23: 543-545
- Hemostatic abnormalities in patients with congestive heart failure: diagnostic significance and clinical challenge.Int J Cardiol. 2000; 75: 15-21
- Relationship between hemostatic abnormalities and neuroendocrine activity in heart failure.Am Heart J. 1994; 127: 607-612
Published online: November 23, 2015
Accepted: November 22, 2015
Received: November 15, 2015
☆These authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.