Hospital mortality in acute coronary syndrome: adjustment of GRACE score by D-dimer enables a more accurate prediction in a prospective cohort study.

ABSTRACT

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.