Aims. The prognostic value of plasma D-dimer in patients with coronary artery disease (CAD) remains controversial. The study is aimed at investigating the relationship between plasma D-dimer levels and in-hospital heart failure (HF) in ST-segment elevation myocardial infarction (STEMI) patients who underwent primary percutaneous coronary intervention (pPCI). Methods. STEMI patients who underwent pPCI were enrolled in this study. Venous blood samples were collected from patients on admission before pPCI procedure. The study endpoint was the occurrence of in-hospital HF. The participants were divided into two groups according to plasma D-dimer levels and further compared baseline D-dimer levels between male and female. Logistic regression and receiver operating characteristic (ROC) curves were performed to evaluate the relationship of D-dimer and in-hospital HF. Results. A total of 778 patients were recruited in the study, of which 539 (69.3%) patients had normal D-dimer levels (≤0.5 mg/L) while 239 (30.7%) had increased D-dimer levels (>0.5 mg/L). The female patients have higher D-dimer levels and higher incident rate of in-hospital HF than that in male patients (). The multivariate logistic regression model revealed that D-dimer was an independent predictor for in-hospital HF in overall population (adjusted odds ratio [OR]: 1.197, 95% CI: 1.003-1.429, and ) and female patients (adjusted OR: 1.429, 95% CI: 1.083-1.885, and ). Conclusion. Increased plasma D-dimer levels were an independent risk factor for incidence of in-hospital HF in STEMI patients who underwent pPCI, especially in female patients, which provides guidance for clinicians in identifying patients at high risk of developing HF and lowering their risk.

中文翻译：

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D-二聚体水平的性别相关差异预测 ST 段抬高型心肌梗塞直接 PCI 后的院内心力衰竭

目标。血浆 D-二聚体对冠状动脉疾病 (CAD) 患者的预后价值仍存在争议。该研究旨在调查接受初次经皮冠状动脉介入治疗 (pPCI) 的 ST 段抬高型心肌梗死 (STEMI) 患者血浆 D-二聚体水平与院内心力衰竭 (HF) 之间的关系。方法. 接受 pPCI 的 STEMI 患者被纳入本研究。在 pPCI 手术前从患者入院时采集静脉血样。研究终点是院内心衰的发生。根据血浆 D-二聚体水平将参与者分为两组，并进一步比较男性和女性之间的基线 D-二聚体水平。采用逻辑回归和接受者操作特征 (ROC) 曲线评估 D-二聚体与院内 HF 的关系。结果。研究共招募了 778 名患者，其中 539 名（69.3%）患者 D-二聚体水平正常（≤0.5 mg/L），239 名（30.7%）患者 D-二聚体水平升高（>0.5 mg/L） ）。与男性患者相比，女性患者的 D-二聚体水平更高，院内心衰发生率也更高。）。多元逻辑回归模型显示，D-二聚体是总体人群中院内 HF 的独立预测因子（调整优势比 [OR]：1.197，95% CI：1.003-1.429，和)和女性患者（调整后的 OR：1.429，95% CI：1.083-1.885，和）。 结论。血浆 D-二聚体水平升高是接受 pPCI 的 STEMI 患者（尤其是女性患者）院内 HF 发生率的独立危险因素，这为临床医生识别发生 HF 的高风险患者并降低其风险提供了指导。