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Correspondence| Volume 204, P42-44, February 01, 2016

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Elevated D-dimer levels predict an adverse outcome in hospitalized patients with acute decompensated heart failure

Published:November 23, 2015DOI:https://doi.org/10.1016/j.ijcard.2015.11.156
      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.
      ,
      • 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.
      ]. 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 [
      • Koracevic G.P.
      Pragmatic classification of the causes of high D-dimer.
      ]. Previous studies have shown that elevated D-dimer levels are present in patients with cardiovascular disease [
      • Yamamoto K.
      • Ikeda U.
      • Furuhashi K.
      • Irokawa M.
      • Nakayama T.
      • Shimada K.
      The coagulation system is activated in idiopathic cardiomyopathy.
      ,
      • 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.
      ], 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 [
      • 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.
      ,
      • 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.
      ]. 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.

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      References

        • 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
        • 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
        • 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
        • 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
        • 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
        • Jafri S.M.
        Hypercoagulability in heart failure.
        Semin Thromb Hemost. 1997; 23: 543-545
        • Davis C.J.
        • Gurbel P.A.
        • Gattis W.A.
        • et al.
        Hemostatic abnormalities in patients with congestive heart failure: diagnostic significance and clinical challenge.
        Int J Cardiol. 2000; 75: 15-21
        • Sbarouni E.
        • Bradshaw A.
        • Andreotti F.
        • Tuddenham E.
        • Oakley C.M.
        • Cleland J.G.
        Relationship between hemostatic abnormalities and neuroendocrine activity in heart failure.
        Am Heart J. 1994; 127: 607-612