Summary
Our previous prospective study of post-infarction patients described a strong and
significant association of increased plasma D-dimer concentrations in those who experienced
a subsequent coronary death or non-fatal myocardial infarction. In the present study,
we compare results on stored plasma obtained two months after the index myocardial
infarction from 1,038 patients of this trial, using a simple automated latex agglutination
(LA) assay in parallel with the standard ELISA test. Results show a somewhat higher
mean value for the LA assay (702 ± 1092 vs. 638 ± 986 ng/ml, p = 0.0002), a strong
linear correlation of the two assays (r = 0.86) and 88% agreement for values below
500 ng/ml by the ELISA test. D-dimer concentrations determined by each assay were
highly correlated in patients with subsequent coronary artery events (p = 0.93) and
quartile values for both the LA and ELISA were equally predictive of such events (p
= 0.003 and p = 0.001, respectively). This is the first demonstration that a latex
agglutination assay for D-dimer can be used to assess the prognostic risk of recurrent
coronary thrombotic disease after myocardial infarction