J Korean Soc Emerg Med.
2009 Aug;20(4):365-371.
Usefulness of D-dimer Test as Early Marker for Predicting Myocardial Infarction in Patients with Acute Coronary Syndrome and non-ST Elevation ECG
- Affiliations
-
- 1Department of Emergency Medicine, School of Medicine, Konkuk University Konkuk University Hospital, Seoul, Korea. 20070123@kuh.ac.kr
- 2College of Nursing, Eulji University, Daejeon, Korea.
Abstract
-
PURPOSE: To determine if D-dimer level is a supportive marker in the prediction of myocardial infarction in patients with acute coronary syndrome and non-ST elevation ECG, who arrive in the emergency room.
METHODS
We conducted a prospective, observational study of patients with acute chest pain that had occurred within 24 hours and who had non-ST elevation on ECG. They were managed according to the 2005 ACLS guidelines; the following clinical tests were performed: D-dimer, cardiac markers, and CAG. Final diagnoses were divided into 3 groups: myocardial infarction (MI), unstable angina (UA), and others (non-specific or angina).
RESULTS
Ninety-three (93) patients were included in this study. The mean D-dimer value was higher in patients diagnosed with MI (1.04+/-2.12 ug/dl) than in those patients diagnosed with UA (0.48+/-0.51 ug/dl) (p=0.026). At the 0.38 ug/dl diagnotic threshold estimated by ROC curve analysis, corresponding to the cutoff for diagnosis of myocardial infarction then in this value sensitivity and specificity of D-dimer were 70.6% and 62.7%. In cardiac enzymes, sensitivity and specificity of Tn-I were 47.1% and 98.3, respectively, and for CK-MB were 35.3% and 98.3%, respectively.
CONCLUSION
D-dimer value may be at higher levels in AMI and the sensitivity of D-dimer was higher than that of TnI andCK-MB in patients with acute coronary syndrome and non- ST elevation ECG. However, because of relatively lower sensitivity and specificity of the D-dimer test, this test may useful as supporting marker for predicting myocardial infarction.
