HEART Score Combined With D-dimer In Predicting Adverse Cardiovascular Events In Patients With Acute Coronary Syndrome

ObjectiveTo study the relationship between D-dimer level and(History&ECG& Age& Risks& Troponin,HEART)score,as well as risk stratification in patients with Acute coronary syndrome(ACS).To investigate the evaluation of D-dimer and HEART score on the severity of the short term prognosis for Acute coronary syndrome(ACS).MethodsThis study is a descriptive study.From July 2016 to June 2017,329 patients with acute coronary syndrome(ACS)from July 2016 to June2017 in Grade 3A Hospital of Changsha City,Hunan Province,were selected as subjects.After admission,the plasma D-dimer levels were measured by immunoturbidimetry.The patients were assessed with HEART score,and the total score was counted to calculate the risk stratification.The relatio-nship between plasma D-dimer level,HEART score and risk stratification in patients with ACS was analyzed by telephone follow-up of cardiovascu lar adverse events within 30 days.Using E Xcel double check and input data,using SPSS21.0 software for statistical analysis(P < 0.05)there was statistical significance.Result1.According to HEART risk stratification,D-dimer was the higest in the high risk group(P<0.05).D-dimer level between middle risk and low risk groups have no significant difference;2.According D-dimer level,patients were stratified into four group by quartile.Compared with the lowest,second,and third quartile.The HEART score was the highest in the fourth quartile(P<0.05).Patients with D-dimer level above 75 percentage had higher ratio of high risk than patients with D-dimer under the 75 percentage(P<0.05);3.The D-dimer level in ACS patients was positively related with HEART risk score(r=0.167,P<0.01);4.ROC analysis showed AUC of on admission D-dimer was0.807(SE=0.017 P=0.001,95%CI 0.774-0.84;)and AUC of HEART risk score was 0.766(SE=0.021 P=0.001,95%CI 0.724-0.808;)for predicting the short-term risk of MACE;5.the AUC of D-dimer combined the HEART risk score was0.837(SE=0.015 P=0.001,95%CI 0.808-0.866;)D-dimer and HEART risk score can improve the prediction of the risk of cardiovascular adverse events in patients within 30 days of onset.Conclusion1、The HEART score can be used as a prediction of ACS is an independent predictor of risk of MACE in patients within 30 days of onset;2、The D-dimer level is valuable parameters for risk stratification in patients with ACS;3、D-dimer level on positively related with HEART risk score,they can improve the prediction of recent risk of MACE in patients with ACS.