D-dimer as Biomarker for Prognosis of Coronary Artery Disease and Heart Failure: Reappraisal of its Central Role.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2025-05-08 DOI:10.1159/000546154

Kainuo Wu, Jonathan Van Name, Lei Xi

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引用次数: 0

Abstract

Background: D-dimer is a fibrinogen degradation product formed by the breakdown of cross-linked fibrin in a series of enzyme-mediated steps. Since the D-dimer assay allows for detection of thrombin production and endogenous fibrinolysis, it has been increasingly used in clinics as a screening test to exclude venous thromboembolism and disseminated intravascular coagulation. Additionally, D-dimer has been evaluated for determining the initiation of anticoagulation therapy in patients with selected cardiovascular disease.

Summary: This narrative review has evaluated the updated evidence from several recent clinical studies/trials and provides a reappraisal of the utility of D-dimer assay for disease prognosis and clinical management decisions in patients with stable coronary artery disease, acute coronary syndrome, and heart failure. We further discussed several confounding factors that may affect circulating levels of D-dimer, including those observed during the COVID-19 pandemic.

Key messages: Better understanding of the pathophysiologic mechanisms underlying D-dimer formation would improve accuracy and specificity of D-dimer as biomarker for predicting long-term outcome of the severity of coronary artery disease and heart failure.

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d -二聚体作为冠状动脉疾病和心力衰竭预后的生物标志物：对其核心作用的重新评估

背景：d -二聚体是一种纤维蛋白原降解产物，由交联纤维蛋白在一系列酶介导的步骤中分解形成。由于d -二聚体检测允许检测凝血酶产生和内源性纤维蛋白溶解，它已越来越多地用于临床作为一种筛选试验，以排除静脉血栓栓塞和弥散性血管内凝血。此外，d -二聚体已被评估用于确定特定心血管疾病患者抗凝治疗的起始。摘要：这篇叙述性综述评估了最近几项临床研究/试验的最新证据，并重新评估了d -二聚体测定在稳定性冠状动脉疾病、急性冠状动脉综合征和心力衰竭患者的疾病预后和临床管理决策中的应用。我们进一步讨论了可能影响循环d -二聚体水平的几个混杂因素，包括在COVID-19大流行期间观察到的因素。关键信息：更好地理解d -二聚体形成的病理生理机制将提高d -二聚体作为预测冠状动脉疾病和心力衰竭严重程度的长期预后的生物标志物的准确性和特异性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.