D-dimer and Other Risk Factors for Cardiac Disease in Adult Patients
Mohamad Ammar Ayass, Sundose Hassan, Gul Nowshad, Ayass Lung Clinic and Sleep Center, Frisco, TX, USA
Background: An estimated 84 million American adults suffer with cardiovascular disease, and with >600,000 deaths annually, risk-identification, accurate diagnosis, treatment and preventive measures at all levels are crucial for better patient outcomes.
Methods: Four hundred patients examined at Ayass Lung Clinic & Sleep Center in San Angelo, Texas in 2013 were included in the study to analyze clinical data for risk assessment of patients for future diseases. Demographic, clinical, and laboratory information were obtained from medical records. Logistic regression models were employed to determine correlates with cardiovascular disease.
Results: Out of 400 patients, 148 (42%) were diagnosed with cardiac disease and 60% have high D-dimer levels (>230 ng/mL). Patients were diagnosed as having cardiac disease by echocardiograph and 70% of them had mitral regurgitation. Sixty percent of cardiac patients were older (>65 years), 53% females and 80% White.
In univariate analysis, the D-dimer, homocysteine, Lupus, deficient DLCo, immunoglobulin IgG deficiency, history of smoking and age were risk factors for cardiac disease. Multivariate analysis showed that the only statistically significant risk factors after adjusting for age, gender and ethnicity were D-dimer, low levels of DLCo, history of smoking and Lupus.
Therefore, patients with D-dimer levels >230 ng/mL were 1.6 times (CI: 1.02-2.49) more likely to develop cardiac disease. Similarly, deficient DLCo (OR= 4.8, CI: 1.02-2.49) and Lupus (OR= 2.8, CI: 1.30-5.96) were strongly associated with occurrence of cardiac disease.
Conclusion: Although the association between D-dimer and cardiac disease suggests role of coagulation activation and endothelial disturbance, further larger scale prospective studies are needed to prove the causality.