Correlation Between the Change Trajectory of D-D/cTnI Ratio in Peripheral Blood and the Clinical Outcome of Patients with Emergency Acute Myocardial Infarction
LU Xiaoli
WANG Fangfang
WANG Junmin
MU Shihai
CAO Fei
Abstract：Objective To investigate the correlation between the change trajectory of D-dimer/cardiac troponin I(D-D/cTnI)ratio in peripheral blood and the clinical outcome of patients with emergency acute myocardial infarction(AMI).Methods A total of 180 patients with AMI admitted to Pingdingshan First People's Hospital from January 2024 to June 2025 were prospectively selected and treated with percutaneous coronary intervention(PCI).The ratio of D-D/cTnI in peripheral blood was measured before PCI,6 h after PCI and 48 h after PCI.The changes of D-D/cTnI ratio during perioperative period were statistically analyzed.The different trajectory groups of D-D/cTnI ratio during perioperative period were screened by establishing latent class trajectory model(LCTM).The clinical outcomes of AMI patients during hospitalization were statistically analyzed.The clinical data of patients with different clinical outcomes were compared.Multivariate logistic regression was used to analyze the effect of D-D/cTnI ratio change trajectory on the clinical outcome of AMI.Receiver operating characteristic(ROC)curve was used to analyze the value of D-D/cTnI ratio change trajectory in predicting the clinical outcome of AMI.Results The levels of D-D and cTnI in all patients increased slightly from before PCI to 6 h after PCI,and the ratio of D-D/cTnI decreased slightly,the levels of D-D and cTnI decreased significantly from 6 h after PCI to 48 h after PCI.The ratio of D-D/cTnI showed a significant upward trend,and the differences were statistically significant(P＜0.05).The LCTM model was constructed,and the model fitting was optimal when the three classification trajectories were identified.According to the optimal model,the D-D/cTnI ratio change trajectory was divided into three trajectory groups(T1 group:high-relatively high;T2 group:medium low-relatively high;T3 group:low-low).There were significant differences in Killip classification,global registry of acute coronary events(GRACE)score and perioperative D-D/cTnI ratio between the poor group and the good group(P＜0.05).Logistic regression analysis showed that after adjusting for confounding factors,the change trajectory of D-D/cTnI ratio was still a related influencing factor of clinical outcome of AMI(P＜0.05).The risk of poor outcome in T2 group and T3 group was 1.524 and 2.129 times higher than that in T1 group(P＜0.05).ROC curve showed that when the change of D-D/cTnI ratio showed a T3 trajectory,the area under the curve for predicting the adverse outcome of AMI was 0.907(0.855-0.945),the sensitivity was 82.93％,and the specificity was 98.56％.Conclusion The D-D/cTnI ratio of AMI patients has different change trajectories before and after PCI,and the risk of adverse outcome is higher when it shows a low-low change trajectory,and it has certain predictive value for adverse outcome.It can be used as an auxiliary method for clinical prediction of clinical outcome,which has certain guiding significance for subsequent clinical decision-making.
Keywords：acute myocardial infarctionD-D/cTnI ratiotrajectory of changeclinical outcomecorrelation
Publication Date：2026-07-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 2571-2576 )