Mushtaq Ahmed, Subhan-ud Din, Noor-ul Hadi, Abdur Rahman, Tajendar Kumar, Jaffar Siddique, Khalid Naseem.
Elevated D-Dimer Levels, a Predictor for Thrombosis in Acute Myocardial Infarction and Unstable Coronary Artery Disease.
J Saidu Med Col Jan ;8(2):128-32.

Background: Myocardial infarction is prominent cardiovascular event worldwide notorious for increase deaths and about 50% deaths have been reported from the developing countries. Atherosclerosis has an inflammatory activity and results in thrombotic complications of which C-reactive protein is most significant marker. Objective: To study D-dimer as Coagulation Activation Marker in Acute Myocardial infarction(STEMI) and non-ST elevation ACS(NSTEMI, USA). Materials & Methods: This study was conducted in the Cardiology Department of MMC Teaching Hospital and Pathology Department Bacha Khan Medical College Mardan from January 2015 to January 2016. The study included 100 patients, 50 acute STEMI, 50 non-ST ACS (NSTEMI, USA) and 50 healthy individuals as a control group. D-dimer levels were performed in all these patients as a Coagulation Activation Marker. Results: Elevated D-dimer level were found in 40 out of 50 patients of Acute Myocardial infarction. 10 patients had D-dimer level (80%) in the range of 250-500ng/ml; 10 patients D-dimer levels were in the range of 500-1000ng/ml and 20 patients D-dimer levels were in the range of 1000-2000ng/ml. Similarly in non-ST ACS 35 out of 50 patients (70%) had elevated D-dimer levels; 5 patients had D-dimer levels in the rage of 250-500 ng/ul and 10 patients had D-dimer level in the range of 500-1000 ng/ul and 20 patients Ddimer level were 1000-2000 ng/ml. D-dimer in both the groups were significantly elevated as compared to the control group (P < 0.0035 for STEMI and P <0.0034 for NSTEMI and USA respectively. Conclusion: The study concluded that Acute Myocardial infarction(STEMI, NSTEMI) and Unstable Angina are associated with significant hemostatic abnormality based on t-test with p-value less than 0.05 as significant. D-dimer assay is a useful marker to diagnose these cardiac emergencies.

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