Role of Serum D-Dimer Level in Acute Coronary Syndrome Patients

Abstract

Background: Chest pain is a frequent symptom in emergency and cardiology department and often presents a diagnostic challenge. Because coronary thrombosis is a hallmark of acute coronary syndromes (ACS), the substrates of the coagulation and fibrinolysis cascades may be considered as a marker of coronary thrombosis. Objectives: The aim of the study was to determine the role of D-dimer value in patients of acute coronary syndrome. Subjects and Methods: A total of 100 ACS patients who admitted in Comilla Medical College Hospital during July 2014 and December 2014 were enrolled in this study. Demographic characteristics were assessed by a standardized questionnaire. Conditions that increased plasma D-dimer other than ACS were excluded. Plasma D-dimer was measured. 2.5 milliliter (ml) of blood was collected from each patient in 3.2% trisodium citrate. D-dimer test was measured immunometrically for all patients regardless of troponin I results.  Results: Total of 100 ACS patients were enrolled. Mean age of these patients were 40.9±12 years. Out of which 59% is male and 41% is female. Plasma D-dimer levels correlated with complication of ACS, creatinine clearance, troponin-I level and Death. D-dimer levels were raised among patients with troponin I positive results and normal in those with negative troponin I results. A significant correlation was found between high D-dimer level and positive troponin I results. Conclusion: D -Dimer, an expression of ongoing thrombus formation and lysis, is a marker of substantial incremental value for the early diagnosis of acute coronary syndromes presenting with chest pain. It adds independent information to the traditional assessment for myocardial infarction. D -Dimer can be incorporated into clinical decision models in the Emergency and Cardiology Department. D-dimer is useful coagulation marker use to evaluate extent of coronary thrombosis and may predict in-hospital cardiovascular complication.