Predictive value of preoperative D-dimer combined with activated partial thromboplastin time for slow/no-reflow phenomenon in emergency percutaneous coronary intervention

doi:10.16016/j.1000-5404.201908090

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Predictive value of preoperative D-dimer combined with activated partial thromboplastin time for slow/no-reflow phenomenon in emergency percutaneous coronary intervention

更新时间：2021-08-02

- Predictive value of preoperative D-dimer combined with activated partial thromboplastin time for slow/no-reflow phenomenon in emergency percutaneous coronary intervention
- Journal of Army Medical University Vol. 41, Issue 20, Pages: 1982-1988(2019)
- 作者机构：
  
  陆军军医大学(第三军医大学)第二附属医院心血管内科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201908090
  CLC： R541.4
- Published：2019，
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[1]刘婷,潘文旭,何云,成小凤,何沛逊,高志春,晋军.术前D-二聚体联合检测活化部分凝血活酶时间对急性冠脉综合征急诊PCI术中慢/无复流现象的预测价值[J].第三军医大学学报,2019,41(20):1982-1988.

Predictive value of preoperative D-dimer combined with activated partial thromboplastin time for slow/no-reflow phenomenon in emergency percutaneous coronary intervention. [J]. Journal of Army Medical University 41(20):1982-1988(2019)
[1]刘婷,潘文旭,何云,成小凤,何沛逊,高志春,晋军.术前D-二聚体联合检测活化部分凝血活酶时间对急性冠脉综合征急诊PCI术中慢/无复流现象的预测价值[J].第三军医大学学报,2019,41(20):1982-1988. DOI： 10.16016/j.1000-5404.201908090.

Predictive value of preoperative D-dimer combined with activated partial thromboplastin time for slow/no-reflow phenomenon in emergency percutaneous coronary intervention. [J]. Journal of Army Medical University 41(20):1982-1988(2019) DOI： 10.16016/j.1000-5404.201908090.

摘要

目的探讨D-二聚体（D-Dimer）联合活化部分凝血活酶时间（activated partial thromboplastin time

APTT）对急性冠状动脉综合征（acute coronary syndrome

ACS）患者行急诊经皮冠状动脉介入治疗（percutaneous coronary intervention

PCI）发生慢/无复流现象的预测价值。方法分析2015年11月至2018年6月间陆军军医大学第二附属医院心血管内科就诊后拟行急诊PCI的ACS患者181例

术前检测所有患者的血浆D-二聚体、APTT等指标

根据TIMI血流分级方法将患者分为慢/无复流组和正常血流组

比较两组间D-二聚体和APTT与慢/无复流发生的相关性

并根据Cutoff值分为高危组和非高危组

比较两组慢/无复流发生率。结果 Logistics多因素回归分析显示本研究总人群中术前D-二聚体（OR=2.801

95%CI=1.399-5.610

P=0.004）和APTT（OR=0.881

95%CI=0.810-0.959

P=0.003）分别与发生慢/无复流现象呈正相关和负相关

ROC曲线分析D-二聚体AUC=0.612（95%CI=0.537-0.683

P=0.036）

APTT AUC=0.653（95%CI=0.579-0.722

P=0.004）

当D-二聚体联合APTT后AUC提高到0.697（95%CI=0.624-0.763

P<0.001）。根据D-二聚体和APTT的Cutoff值分组

高危组中慢/无复流的发生率较非高危组明显升高

分别为36.17%和14.92%（P=0.002）。结论 D二聚体越高

慢/无复流发生率越高

而术前活化部分凝血活酶时间与慢/无复流发生率呈负相关

联合检测D-二聚体和活化部分凝血活酶时间水平有助于预测ACS患者行急诊PCI术中慢/无复流现象的发生。

Abstract

Objective To investigate the predictive value of D-dimer combined with activated partial thromboplastin time(APTT) for slow/no-reflow of percutaneous coronary intervention(PCI) in patients with acute coronary syndrome(ACS). Methods A total of 181 ACS patients undergoing emergency PCI in our department from November 2015 to June 2018 were recruited in this study. Their plasma D-dimer level and APTT were tested before surgery. According to thrombolysis in myocardial infarction(TIMI)

the patients were divided into slow/no-reflow group and normal blood flow group. The correlations of D-dimer level and APTT were analyzed with the incidence of slow/no-reflow. According to the cutoff values of the 2 indicators

the patients were assigned into high-risk group and non-high-risk group

and the incidence of slow/no-reflow was compared between the 2 groups. Results Logistics multivariate regression analysis showed preoperative D-dimer(OR=2.801

95% CI=1.399～5.610

P=0.004) was positively

and APTT(OR=0.881

95%CI=0.810～0.959

P=0.003) was negatively correlated with slow/no-reflow phenomenon. According to ROC curve

D-dimer AUC=0.612(95% CI=0.537～0.683

P=0.036)

APTT AUC=0.653(95% CI=0.579～0.722

P=0.004)

and AUC increased to 0.697(95% CI=0.624～0.763

P<0.001) when D-dimer was combined with APTT index. According to the cutoff values of D-dimer and APTT

the incidence of slow/no-reflow in high-risk and non-high-risk groups was 36.17% and 14.92%

respectively(P=0.002). Conclusion Higher preoperative D-dimer indicates higher incidence of slow/no-reflow in ACS patients after emergency PCI

while preoperative APTT is negatively correlated with the incidence. So combined detection of the 2 indicators helps predict the occurrence of slow/no-reflow in the patients.

关键词

D-二聚体活化部分凝血活酶时间急性冠脉综合征经皮冠状动脉介入治疗慢/无复流预测价值

Keywords

D-dimeractivated partial thromboplastin timeacute coronary syndromepercutaneous coronary interventionno-reflowpredictive value

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