To determine the predictive value of plasma fibrin D-dimer for coronary heart disease (CHD) events in the general population, we performed a nested case-control study in stored, citrated plasma samples from the Scottish Heart Health Study of 5093 men and 4862 women. Fibrinogen (Clauss assay) has already been measured in all these samples, and related to risk of CHD events. Plasma D-dimer (ELISA; AGEN) was measured in 248 cases of incident CHD and 762 controls, matched for baseline CHD, age, sex, district and time of examination. Exclusions were: - baseline doctor-diagnosed CHD or ECG evidence of MI (Q/QS on ECG); deaths due to other causes; or migration. The average follow-up period was 7.7 years. Baseline plasma D-dimcr levels were higher in cases (median 92ng/ml; IQR 62-154) than in controls (85; 56-133). The odds ratio for incident CHD in the upper tertile of D-dimer was 1.50 (95% CI 1.02, 2.22; p<0.05). D-dimer was related to fibrinogcn in cases (r=0.19, p=0.003) and controls r=0.18, p<0.001): adjustment for fibrinogen modified the predictive value of Ddimer only slightly. We conclude that D-dimer is a predictor of CHD in the general population, suggesting a role for increased fibrin turnover in the pathogcncsis of CHD.
|Original language||English (US)|
|Number of pages||1|
|Issue number||SUPPL. 3|
|State||Published - Dec 1 1996|
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