Value of serum D-dimer level in predicting short-term prognosis in patients with acute heart failure
He Mingyi
Wang Jing
Zhai Wenliang
Wang Tao
Wang Zheng
Wang Changyuan
Abstract：study the clinical value of serum D-dimer (D-D) level in predicting short-term prognosis in patients with acute heart failure (AHF). Methods The clinical materials were retrospectively analyzed in AHF patients (n=86) chosen from Beijing Xuanwu Hospital affiliated to Capital University of Medical Sciences from Apr. 2016 to Oct. 2018. The patients died due to cardiovascular diseases and those were re-hospitalized due to heart failure were recorded (observation group) and other patients were chosen into control group from admission to discharging for 6 months. The samples of fasting vein blood within 24 h after admission were collected and detected, and then levels of serum D-D and cystatin C (Cys C) were compared in 2 groups. The grades of NYHA classification of heart function were recorded in all patients, and levels of serum D-D and Cys C were compared among patients with different NYHA grades. The value of D-D and Cys C in predicting short-term poor prognosis was analyzed by using receiver operating curve (ROC). Results Among 86 cases, 26 were chosen into observation group due to short-term poor prognosis, and 3 died due to heart failure during hospitalization, 5 died due to stroke during follow-up period, 2 died due to ischemic heart disease and 16 were re-hospitalized due to heart failure. The levels of serum D-D and Cys C were significantly higher in observation group than those in control group (P<0.05). The levels of serum D-D and Cys C were significantly higher in patients with grade Ⅲ of NYHA than those with grade Ⅱ of NYHA, and were significantly higher in patients with grade IV of NYHA than those with grades Ⅱ and Ⅲ of NYHA (P<0.05). The results of ROC analysis showed that area under curve (AUC) of serum D-D level in predicting AHF short-term poor prognosis was 0.751 (SE=0.056, P=0.000, 95%CI:0.640~0.862), and the sensitivity was 0.808, specificity was 0.683 and optimal cutoff value was 1.61 mg/L. AUC of serum Cys C in predicting AHF short-term poor prognosis was 0.693 (SE=0.059, P=0.005, 95%CI:0.577~0.808), and specificity was 0.823, specificity was 0.517 and optimal cutoff value was 1.77 mg/L. The combined detection of serum D-D and Cys C levels showed the specificity was 0.885, specificity was 0.817 and accuracy was 0.837. Conclusion The levels of serum D-D and Cys C are correlated to heart function in AHF patients, and combined detection of serum D-D and Cys C levels has higher accuracy in predicting short-term prognosis in clinical practice.
Keywords：Serum D-dimerCystatin CAcute heart failureShort-term prognosis
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1205-1207,1211 )