The Correlation Between Plasma Level Of D-dimer And Degree Of Coronary Lesions In Acute Myocardial Infarction

Objective In this study,we analyzed the plasma D-dimer levels in patients with acute myocardial infarction through retrospective analysis,aiming at investigating the correlation between D-dimer and degree of coronary lesions in patients with acute myocardial infarction.Methods 538 patients were chosen in the Affiliated Hospital of Southeast University from January 2015 to March 2018,which were divided into two groups,AMI group(n=473)and control group(n=65).The level of plasma D-dimer in the two groups was compared.According to the results of coronary angiography,we then divided AMI group into two subgroups,single vessel lesion group and multi-vessel lesion group.Then we compared the different level of the D-dimer in these two subgroups.Then we calculated the Gensini score of the patients in AMI group,and divided AMI group into two subgroups by the second category,low Gensisi score group(0?GSlow?54)and high Gensini score group(GShigh?55).In the same way we compared the level of D-dimer in these two subgroups.Finally,multivariate Logistic regression analysis was used to compare the correlation between the incidence of the level of D-dimer and acute myocardial infarction,the number of coronary lesion branches in acute myocardial infarction patients and the Gensini score acute myocardial infarction patients.Results(1)The plasma D-dimer level in AMI group(218.74�233.00)ug/L was higher than that in control group(38.18�70.23)ug/L(P<0.05).(2)The plasma D-dimer level in single vessel lesion group(154.64�168.16)ug/L lower than that in multi-vessel lesion group(233.19�243.10)ug/L(P>0.05).(3)Comparing to low Gensisi score group,the level of plasma D-dimer was significantly higher in high Gensini score group(P<0.05).(4)538 patients enrolled in this study(473 cases in AMI group,and 65 cases in control group)was analyzed by multiariable Logistic regression analysis,we found that the acute myocardial infarction patients plasma D-dimer level was higher than that of the control group obviously,and after adjusted by smoking history,D-dimer level is positively correlated with acute myocardial infarction(OR = 0.997,P < 0.05),which indicated that D-dimer is one of the independent risk factors of AMI.(5)The multivariable Logistic regression analysis on AMI group showed that the D-dimer level in the patients with multi-vessel disease is significantly higher than that in the single lesion group,and after adjusted by gender and age,D-dimer level and coronary lesions were still positively correlated(OR = 1.002,P < 0.05),indicating that D-dimer is an independent risk factor to the number of diseased coronary vessels.(6)A multiariable Logistic regression analysis on the patients of acute myocardial infarction showed that gender,age,total cholesterol,triglyceride,smoking,hypertension,diabetes,body mass index,D-dimer level are not independent risk factors to the Gensini score.Conclusion(1)The plasma D-dimer level reflects a high coagulation state and secondary fibrinolytic function,which was positively correlated with the onset of acute myocardial infarction.It was an independent risk factor of acute myocardial infarction,and has clinical significance.in the diagnosis of acute myocardial infarction.(2)D-dimer level were positively correlated with the number of diseased coronary vessels in patients with acute myocardial infarction,and it was also associated with the Gensini score,which showed that D-dimer level had a certain relevance with the severity of coronary lesions in patients with acute myocardial infarction.To some extent,it can react the severity of coronary lesion in patients with acute myocardial infarction.D-dimer had a certain guiding significance on clinical diagnosis and treatment of acute myocardial infarction.