Initially presented acute coronary syndrome: does D-dimer imply any clinical significance?

• Published in: The Egyptian journal of haematology : the official journal of the Egyptian Society of Haematology 2020-01, Vol.45 (1), p.23-27
• Main Authors: Mansour, Hazem, El-Sakhawy, Yasmin
• Format: Article
• Language: English
• Subjects: Coronary heart disease; Emergency medical services; Enzymes; Fibrin; Medical research; Pulmonary embolism
• ISSN: 1110-1067; 2090-9268
• DOI: 10.4103/ejh.ejh_40_19

Background D-Dimer is an enzymatic degradation product that is formed as a result of breakdown of cross-linked fibrin clots by plasmin. The plasma level of D-dimer is vital for evaluating the patient's fibrinolytic status. D-dimer testing was proven to be beneficial marker in the identification of deep vein thrombosis of the lower limbs and pulmonary embolism [16]. The relationship between the level of D-dimer levels & acute coronary syndrome is uncertain and conflicting. Aim The aim of this study was to assess D-dimer levels in patients presented to the emergency room (ER) with acute chest pain. Subjects and methods The first group involved those diagnosed with acute coronary syndrome (ACS); which included unstable angina pectoris [UA], non-ST elevated myocardial infarction [NSTEMI], ST-elevated myocardial infarction [STEMI]); the control group involved those diagnosed with non-cardiac chest pain. The serum levels of D-dimer, creatine kinase-MB (CK-MB) and troponin I (TPI) were assessed in the two groups. Results Levels of D-dimer, CK-MB and TPI was higher in the patient group. There were also higher D-dimer, CK-MB and TPI levels in the STEMI and NSTEMI patient subgroups as compared with the control group. Merely the D-dimer level was higher in the UA subgroup as compared with the control group. Conclusion D-dimer levels assessment seemed to be useful in the ER for identifying ACS patients and to predict mortality hazards in patients presenting with acute chest pain.