Use of anticoagulation and D-dimer levels in patients with acute heart failure

Introduction

Decompensated heart failure (DHF) is associated with several coagulation disturbances, including elevation of the circulating D-dimer levels, contributing to pathophysiology and thromboembolic events. The influence of oral anticoagulant on D-dimer levels in patients with HF has not been established.

Objective

To verify whether oral anticoagulant treatment would influence D-dimer levels in patients with DHF.

Materials and methods

A cohort study with 70 patients admitted with DHF (85.7% NYHA FC IV) to the coronary care unit during 1 year. Of this sample, 53 patients had a D-dimer dosage on admission and were divided into two groups: group A (GA = 8 patients) with oral anticoagulant; and group B (GB = 45 patients) without oral anticoagulant. The Student t test was performed for the analysis.

Results

GA and GB were similar with respect to mean age (78.7 ± 11.8 vs 77.0 ± 10.1 years) and male gender (37.5% vs 57.7%). The mean INR (GA) was 4.09 ± 2.61. There was no difference in admissional D-dimer levels between GA and GB (GA = 1326.5 mg/dl vs GB = 1426.2 mg/dl, P = 0.81).

Conclusions

This study indicated that oral anticoagulant therapy did not influence circulating D-dimer levels, despite adequate anticoagulation, suggesting that this therapy does not completely protect against all coagulation abnormalities observed in DHF.