关键词: D-二聚体, 慢性心力衰竭, 高凝状态, 血栓风险

Abstract:

Objective To evaluate the risk of thrombosis in chronic heart failure (CHF) and study the clinical value by detecting the plasma D-dimer. Methods 117 CHF patients were classified into gradeⅠ(41 cases), Ⅱ (38 cases) and Ⅲ(38 cases) according to the criteria of New York Heart Association (NYHA). 50 healthy subjects were included as control group. Biomerieux VIDAS fluorescence enzyme linked immunoassay analyzer was used to test the D-dimer. Kaplan-Meier curve was used to implement survival analysis, and receiver operating characteristic (ROC) curve was performed to analyze the diagnosis performance of D-dimer. χ² test was used to analyze the relevance between D-dimer and clinical pathological factors. Results The levels of D-dimer increased with the upgrade of HYHA classification. Each group showed the statistically significant difference (P<0.01) and all were higher than the control group (P<0.01). The level of D-dimer in the thrombosis group was significantly higher than the non-thrombosis group (P<0.01). When the cut-off value of D-dimer was 2 091 ng/mL, the sensitivity was 100% and the specificity was 69% in diagnosing the risk of thrombosis in CHF. The level of D-dimer in CHF was correlated with age, the main lesions and the history of myocardial infarction (P<0.01). The cumulative probability of thrombosis within 90 days in the CHF patients whose level of D-dimer was above the cut-off value (2 091 ng/mL) increased significantly (Log-rank χ²=59.821, P=0.000). Conclusions The plasma D-dimer is correlated with various clinical pathological factors in CHF, which can reflect the severity of CHF disease and assess effectively the risk of thrombosis in CHF.

Key words: D-dimer, Chronic heart failure, Hypercoagulable state, Thrombosis risk