ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
This article is part of the Research TopicSurgical Treatment and Perioperative Organ Protection for Coronary Heart Disease and Comorbid Chronic DiseasesView all 8 articles
Association of D-dimer levels with in-hospital death and multi-vessel coronary artery disease in patients with non–ST-segment elevation acute coronary syndrome
Provisionally accepted
Ning Zhang1
Baorong Niu2*- 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
- 2Beijing Anzhen Hospital, Capital Medical University, Chaoyang District, China
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Introduction: To determine the association of D-dimer levels with in-hospital death and coronary artery disease (CAD) in patients with non–ST-segment elevation acute coronary syndrome (NSTEACS). Methods: We retrospectively analyzed the data of 803 NSTEACS patients admitted to Beijing Anzhen Hospital between January 2022 and January 2024. Demographic, clinical, and laboratory data were compared between survivors (792 patients) and non-survivors (11 patients). Risk factors for in-hospital death were analyzed. The cutoff plasma D-dimer level was determined using the Youden index to predict in-hospital death in patients with NSTEACS, and the rates of in-hospital mortality and multi-vessel CAD (2-vessel + 3-vessel disease) were compared between patients with high (103 patients) and low D-dimer levels (700 patients). Results: D-Dimer [odds ratio (OR): 1.003, P = 0.033, 95% confidence interval (CI): 1.000– 1.006], Global Registry of Acute Coronary Events score (OR: 3.174, P < 0.001, 95% CI: 1.686–5.977), multi-vessel CAD (OR: 6.118, P = 0.013, 95% CI: 1.468–25.499), and Thrombolysis in Myocardial Infarction score (OR: 1.060, P = 0.002, 95% CI: 1.022–1.099) were independently associated with in-hospital death. The area under the receiver operating characteristic curve of D-dimer was 0.781 (P = 0.001, 95% CI: 0.634–0.927). The maximum Youden index was 0.607, with a cutoff of 504 ng/mL distinguishing high and low risk of in-hospital death in NSTEACS patients. In-hospital mortality (8/103 vs. 3/700, P < 0.001) and multi-vessel CAD rates (47/103 vs. 222/700, P = 0.003) were higher in the high D-dimer group. Conclusions: The higher the D-dimer level in NSTEACS patients, the higher the risk of in-hospital death and the higher the probability of multi-vessel CAD. D-Dimer levels were significantly associated with in-hospital death and multi-vessel CAD in NSTEACS patients.
Keywords: non–ST-segment elevation acute coronary syndrome, D-dimer dimerization, Riskfactors, In-hospital death, extent of coronary artery lesions
Received: 06 Aug 2025; Accepted: 04 Nov 2025.
Copyright: © 2025 Zhang and Niu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Baorong Niu, nbr03091028@163.com
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