Fibrin D-dimer and coronary heart disease - Prospective study and meta-analysis

Background-It is unknown whether modest increases of fibrin D-dimer, a circ ulating marker of fibrin turnover, are relevant to coronary heart disease ( CHD) in the general population. Methods and Results-We measured serum concentrations of D-dimer antigen in the stored baseline blood samples of 630 CHD cases and 1269 controls "neste d" in a prospective cohort of 5661 men who were monitored for 16 years, and we conducted a meta-analysis of previous relevant studies to place our fin dings in context. In a comparison of men in the top third compared with tho se in the bottom third of baseline fibrin D-dimer values (tertile cutoffs, > 94 versus < 49 ng/mL), the odds ratio for CHD was 1.67 (95% CI, 1.31 to 2 .13; P <0.0001) after adjustments for age and town. The odds ratio increase d slightly after further adjustment for smoking, other classic risk factors , and indicators of socioeconomic status (1.79; 95% CI, 1.36 to 2.36). Stro ng correlations were observed of fibrin D-dimer values with circulating con centrations of C-reactive protein and serum amyloid A protein but not with smoking, blood lipids, blood pressure, and other risk factors. Conclusion-Although there may be an association between circulating D-dimer values and CHD, further studies are needed to determine the extent to whic h this is causal.