Last update:

   30-Oct-2001
 

Arch Hellen Med, 2000, 17(Supplement):133-136

ORIGINAL PAPER

Fibrin degradation products (D-dimers) in acute myocardial infarction

E. SINIORAKIS, K. PATRIS, C. BRINIAS, P. TSONOU, S. ARVANITAKIS, P. BONORIS
Department of Cardiology, “Elpis” General Municipal Hospital, Athens, Greece

 


OBJECTIVE To check if the detection of D-dimers (DD) in patients (pts) with acute myocardial infarction (AMI) is a prognostic marker of increased morbidity and in-hospital mortality.
METHOD Eighty-seven consecutive pts (M/F=54/33, mean age=67±12 years) were enrolled. Pts with commorbidities which could affect blood coagulation, were excluded. Plasma DD were evaluated on admission, before administration of any drastic therapy, by semiquantitative method (FDP-Slidex bioMerieux), and daily ever since. Thirty-eight pts with positive DD were included in group A, while group B consisted of 49 pts with negative DD. All pts received aspirin and low molecular weight (LMW) heparin, while 30 pts who were thrombolysed received intravenous heparin for 5 days and LMW form subsequently. For every subject, demographics, peak troponin I, Killip Class of heart failure in the frst day, major arrhythmias, and mortality were recorded. The above parameters were compared between the two groups by the t-test and chi-square, and P<0.05 was considered as statistically significant.
RESULTS Demographics, peak troponin I and Killip stage were similar in the two groups. Despite that, group A presented a fourfold increase in episodes of paroxysmal atrial fibrillarion (AF) between days 2–5, and a fourfold increase in mortality due to heart failure. Thrombolysis and heparin administration did not modify DD. Similarly, pharmacological and/or electrical conversion of AF did not change the original classifcation of pts.
CONCLUSIONS Detection of DD in pts with AMI, suggests a hypercoagulability which can be expressed later under form of AF and heart failure. Thrombolysis, heparin, and cardioversion do not affect DD production. Late heart failure causes a high mortality, and cannot be predicted by classic prognostic markers. Pts with AMI and positive DD constitute a high risk group and warrant increased vigillance.

Key words: Atrial fibrillation, Fibrin degradation, Mortality, Myocardial infarction.


© 2001, Archives of Hellenic Medicine