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Measurement of D-dimer after the off-pump coronary artery bypass grafting in the patients with non-ST-segment elevation myocardial infarction / 中华检验医学杂志
Chinese Journal of Laboratory Medicine ; (12): 222-226, 2014.
Article in Chinese | WPRIM | ID: wpr-444537
ABSTRACT
Objective To study the variation of D-dimer after the off-pump coronary artery bypass grafting(OPCAB),and to evaluate its value for the assessment of postoperative cardiovascular ischemia events.Methods This is a retrospective cohort study.203 patients with non-ST-segment elevation myocardial infarction(NSTEMI) were random selected from the Tianjin medical university general hospital from 2010 to 2012,including 151 males and 52 females with a mean age of (66.9 ±8.4) years.The level of D-dimer was analysed by using the Biomerieux VIDAS fluor-euzymelinked immunoassay Analyzer assay.Receiver operating characteristic curve (ROC) was used to evaluate the sensitivity and specificity,the relevance between D-dimer and clinical pathological factors was analysed by x2 test,the effect on prognosis was evaluated by using cox regression analysis model.Results Compared the group with stable disease,the level of D-dimer was increased remarkable in the group with poor recovery on the 14th day after surgery,(U =75.09,P <0.01).The optimum cut-off point with D-dimer(the 14th day after surgery) for the diagnosis of ischemic events within the 31th-90th day after surgery was 2 590μg/L,the area under ROC curve was 0.867(95% confidence interval0.791-0.943).The logistic analysis showed that the D-dimer was influenced by the sex,age,left ventricular ejection fraction,left main coronary artery disease,the number of vascular with bypass grafts,using internal mammary artery,hypertension and other factors,OR value was 0.495(95% CI0.327-0.694),0.527(95% CI0.370-0.812),0.564(95% CI0.419-0.638),0.331(95% CI0.278-0.426),0.592(95% CI0.440-0.785),2.093(95% CI1.533-2.856),0.580 (95 % CIO.451-0.709) respectively (P < 0.01).The Cox analysis showed that the level of Ddimer on the 14th day after surgery was not the independent assessment parameter for long-term prognosis.Conclusion The serum D-dimer was influenced by multiple pathological factors after the OPCAB,the level of serum D-dimer(on the 14th day after surgery) could be used as effective estimate parameter for the adverse events within the 31 th-90th after OPCAB.

Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Prognostic study Language: Chinese Journal: Chinese Journal of Laboratory Medicine Year: 2014 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Observational study / Prognostic study Language: Chinese Journal: Chinese Journal of Laboratory Medicine Year: 2014 Type: Article