This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Koenig, W. Articles by Brenner, H. Search for Related Content PubMed PubMed Citation Articles by Koenig, W. Articles by Brenner, H. Related Collections Risk Factors Fibrinolysis Epidemiology

(Arteriosclerosis, Thrombosis, and Vascular Biology. 2001;21:1701.)
© 2001 American Heart Association, Inc.

Thrombosis

Plasma Fibrin D-Dimer Levels and Risk of Stable Coronary Artery Disease

Results of a Large Case-Control Study

Wolfgang Koenig; Dietrich Rothenbacher; Albrecht Hoffmeister; Martin Griesshammer; Hermann Brenner

From the Department of Internal Medicine II-Cardiology (W.K., A.H.), University of Ulm Medical Center, and the Department of Epidemiology (D.R., H.B.), University of Ulm, Ulm; the Department of Epidemiology (D.R., H.B.), German Center for Research on Ageing, University of Heidelberg, Heidelberg; and the Department of Internal Medicine III-Hematology and Oncology (M.G.), University of Ulm Medical Center, Ulm, Germany.

Correspondence to Hermann Brenner, MD, Department of Epidemiology, German Center for Research on Ageing, Bergheimerstr 20, D-69115 Heidelberg, Germany. E-mail brenner{at}dzfa.uni-heidelberg.de

Abstract— Increased levels of fibrin D-dimer are indicative of a hypercoagulable state, as found in acute coronary syndromes. Few well-controlled studies have assessed D-dimers in patients with stable coronary artery disease (CAD). We measured levels of D-dimers (in ng/mL by enzyme-linked immunosorbent assay) in 312 patients with angiographically proved CAD and stable angina pectoris and in 477 age- and sex-matched healthy blood donors. Demographic characteristics were assessed by a standardized questionnaire, and a complete lipid profile was performed for all subjects. In addition, a variety of other markers of hemostasis and inflammation were measured. The distribution of D-dimer levels was skewed to the right, and plasma median levels were higher in cases than in controls (median: 11.2 vs 2.8 ng/mL; P<0.001). In controls, correlations of D-dimer were found with fibrinogen, plasma viscosity, and interleukin-6. In logistic regression analysis, the age- and sex-adjusted odds ratio (OR) for the presence of CAD was 2.6 (95% confidence interval [CI], 1.9 to 3.5) when the highest quartile of the D-dimer distribution was compared with the combined lower 3 quartiles. The OR did not change appreciably after controlling for nonlipid risk factors (OR, 2.7; 95% CI, 1.9 to 3.9) and remained significant after further adjustment for other hemostatic parameters (OR, 2.4; 95% CI, 1.7 to 3.3) and markers of inflammation (OR, 2.1; 95% CI, 1.5 to 2.9). Plasma D-dimer levels are strongly and independently associated with the presence of CAD in patients with stable angina pectoris. These results support the concept of a contribution of intravascular fibrin to atherothrombogenesis.

Key Words: D-dimer • hemostasis • inflammation • coronary artery disease • case-control study

This article has been cited by other articles:

				A. Undas, J. Brozek, M. Jankowski, Z. Siudak, A. Szczeklik, and H. Jakubowski Plasma Homocysteine Affects Fibrin Clot Permeability and Resistance to Lysis in Human Subjects Arterioscler Thromb Vasc Biol, June 1, 2006; 26(6): 1397 - 1404. [Abstract] [Full Text] [PDF]

				D. Rothenbacher, S. Muller-Scholze, C. Herder, W. Koenig, and H. Kolb Differential Expression of Chemokines, Risk of Stable Coronary Heart Disease, and Correlation with Established Cardiovascular Risk Markers Arterioscler Thromb Vasc Biol, January 1, 2006; 26(1): 194 - 199. [Abstract] [Full Text] [PDF]

				J. Hetzel, B. Balletshofer, K. Rittig, D. Walcher, W. Kratzer, V. Hombach, H.-U. Haring, W. Koenig, and N. Marx Rapid Effects of Rosiglitazone Treatment on Endothelial Function and Inflammatory Biomarkers Arterioscler Thromb Vasc Biol, September 1, 2005; 25(9): 1804 - 1809. [Abstract] [Full Text] [PDF]

				A. Decensi, P. Maisonneuve, N. Rotmensz, D. Bettega, A. Costa, V. Sacchini, A. Salvioni, R. Travaglini, P. Oliviero, G. D'Aiuto, et al. Effect of Tamoxifen on Venous Thromboembolic Events in a Breast Cancer Prevention Trial Circulation, February 8, 2005; 111(5): 650 - 656. [Abstract] [Full Text] [PDF]

				G. D.O. Lowe, A. Rumley, A. D. McMahon, I. Ford, D. St. J. O'Reilly, C. J. Packard, and for the West of Scotland Coronary Prevention Study Interleukin-6, Fibrin D-Dimer, and Coagulation Factors VII and XIIa in Prediction of Coronary Heart Disease Arterioscler Thromb Vasc Biol, August 1, 2004; 24(8): 1529 - 1534. [Abstract] [Full Text] [PDF]

				P. Prandoni, F. Bilora, A. Marchiori, E. Bernardi, F. Petrobelli, A. W.A. Lensing, M. H. Prins, and A. Girolami An Association between Atherosclerosis and Venous Thrombosis N. Engl. J. Med., April 10, 2003; 348(15): 1435 - 1441. [Abstract] [Full Text] [PDF]

				N. Marx, J. Froehlich, L. Siam, J. Ittner, G. Wierse, A. Schmidt, H. Scharnagl, V. Hombach, and W. Koenig Antidiabetic PPAR{gamma}-Activator Rosiglitazone Reduces MMP-9 Serum Levels in Type 2 Diabetic Patients With Coronary Artery Disease Arterioscler Thromb Vasc Biol, February 1, 2003; 23(2): 283 - 288. [Abstract] [Full Text] [PDF]