Abstract: Objective To investigate the relationship between D-dimer and the risk of cardiac death in patients with acute myocardial infarction (AMI). Methods From January 2013 to January 2020, 3 990 patients admitted in Beijing Friendship Hospital with AMI were included in the present study. Patients were divided into 3 groups according to D-dimer:≤0.50 mg/L, 0.51-0.80 mg/L,≥0.81 mg/L. We used Cox proportional hazard regression to evaluate the influence of D-dimer on cardiac death. Results The patients in D-dimer≥0.81 mg/L group were older, thinner, more likely to be female, had higher prevalence of hypertension, diabetes, and multivessel disease, lower estimated glomerular filtration rate, higher levels of N-terminal pro-brain natriuretic peptide, and more likely to have left ventricular ejection fraction<50%. The cardiac mortality rate was highest in D-dimer≥0.81 mg/L group. After adjusting for other risk factors, D-dimer remained an independent risk factor of cardiac death in patients of AMI (HR=1.71,95%CI: 1.34-2.18,P<0.001). Conclusion Higher level of D-dimer reflected the severity of disease in patients with AMI. In addition, D-dimer was an independent risk factor of cardiac death in patients with AMI.

Key words: acute myocardial infarction, D-dimer, cardiac death