急性冠状动脉综合征患者的住院死亡率：前瞻性队列研究中，通过 D-二聚体调整 GRACE 评分可更准确地预测。
Hospital mortality in acute coronary syndrome: adjustment of GRACE score by D-dimer enables a more accurate prediction in a prospective cohort study.
机构信息
Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.
出版信息
BMC Cardiovasc Disord. 2019 Nov 10;19(1):252. doi: 10.1186/s12872-019-1239-4.
BACKGROUD
To assess the value of D-dimer and its combination with The Global Registry of Acute Coronary Events (GRACE) score in predicting in-hospital mortality in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
METHODS
In 5923 ACS patients undergoing PCI, the role of D-dimer and the added value of D-dimer to GRACE score for predicting in-hospital mortality were tested.
RESULTS
After multivariable adjustment, D-dimer could significantly predict in-hospital mortality. Also, it could significantly improve the prognostic performance of GRACE score (C-statistic: z = 2.269, p = 0.023; IDI: 0.016, p = 0.032; NRI: 0.291, p = 0.035).
CONCLUSION
In patients with ACS undergoing PCI, D-dimer was an independent predictor of in-hospital death. It could also improve the prognostic performance of GRACE score.
背景
评估 D-二聚体及其与全球急性冠状动脉事件注册（GRACE）评分联合用于预测行经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者住院死亡率的价值。
方法
在 5923 例行 PCI 的 ACS 患者中，测试 D-二聚体的作用以及 D-二聚体对 GRACE 评分预测住院死亡率的附加价值。
结果
经多变量调整后，D-二聚体可显著预测住院死亡率。此外，它还可显著改善 GRACE 评分的预后性能（C 统计量：z=2.269，p=0.023；IDI：0.016，p=0.032；NRI：0.291，p=0.035）。
结论
在接受 PCI 的 ACS 患者中，D-二聚体是住院死亡的独立预测因子。它还可以改善 GRACE 评分的预后性能。
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