Fan Xin, Min Tingting, Su Shaohui, Xiong Bin, Wan Huaibin
Department of Cardiology, Dongguan People's Hospital, The First School of Clinical Medicine, Southern Medical University, Dongguan, China.
Department of Cardiology, Heyuan Shenhe People's Hospital, The Fifth Affiliated Hospital of Jinan University, Guangzhou, China.
Front Cardiovasc Med. 2022 Oct 19;9:896173. doi: 10.3389/fcvm.2022.896173. eCollection 2022.
To analyze the predictive values of D-dimer in Chinese patients with non-ST-segment elevation myocardial infarction (NSTEMI).
We retrospectively retrieved consecutive patients hospitalized due to acute NSTEMI from January 2015 to December 2018 from the Electronic Medical Record (EMR) library. Clinical and follow-up data were collected. The primary endpoint was major adverse composite cardiovascular events (MACEs), such as all-cause death, non-fatal myocardial infarction, and non-fatal stroke. The secondary endpoints included all-cause death, non-fatal myocardial infarction, non-fatal stroke, heart failure, and severe arrhythmias. The Cox regression model was used to evaluate the association between risk factors and clinical outcomes in Chinese patients with NSTEMI.
A total of 673 patients were included; the median age was 64.0 (53.0-75.0) years old and 76.2% were men. Patients with higher D-dimer levels were more often women, older, had a higher Charlson Comorbidity Index, and had a higher incidence of MACEs (59.9 vs. control 9.0%; < 0.001) and all-cause death (49.1 vs. control 2.2%; < 0.001). The multivariate Cox analysis suggested that the D-dimer level was an independent predictor of MACEs (hazard ratio [HR]: 1.069, 95% CI: 1.010-1.132, = 0.021). The receiver operating characteristic (ROC) analysis suggested that D-dimer levels were better than the Charlson Comorbidity Index in all-cause death.
In Chinese patients with acute NSTEMI, higher D-dimer levels on admission suggest a poor long-term prognosis.
分析D - 二聚体对中国非ST段抬高型心肌梗死（NSTEMI）患者的预测价值。
我们回顾性地从电子病历（EMR）库中检索了2015年1月至2018年12月因急性NSTEMI住院的连续患者。收集临床和随访数据。主要终点是主要不良复合心血管事件（MACE），如全因死亡、非致命性心肌梗死和非致命性卒中。次要终点包括全因死亡、非致命性心肌梗死、非致命性卒中、心力衰竭和严重心律失常。采用Cox回归模型评估中国NSTEMI患者危险因素与临床结局之间的关联。
共纳入673例患者；中位年龄为64.0（53.0 - 75.0）岁，男性占76.2%。D - 二聚体水平较高的患者女性更多、年龄更大、Charlson合并症指数更高，且发生MACE的发生率更高（59.9%对对照组9.0%；<0.001）以及全因死亡发生率更高（49.1%对对照组2.2%；<0.001）。多变量Cox分析表明，D - 二聚体水平是MACE的独立预测因子（风险比[HR]：1.069，95%可信区间：1.010 - 1.132，P = 0.021）。受试者工作特征（ROC）分析表明，在全因死亡方面，D - 二聚体水平优于Charlson合并症指数。
在中国急性NSTEMI患者中，入院时较高的D - 二聚体水平提示长期预后不良。
