Predictive Value of A Combined Model Based on Age,D-dimer,Albumin and PARIS/GRACE Scores for Prognosis in AMI Patients after Percutaneous Coronary Intervention
YANG Bo
LI Wenjie
CHEN Yinping
ZOU Xiao
Abstract：Objective To investigate the predictive performance of a scoring system based on age,D-dimer,and albumin(ADA)in the prognostic assessment of acute myocardial infarction patients undergoing percutaneous coronary intervention(PCI).Method A total of 150 acute myocardial infarction patients who underwent PCI at Suixi Hospital of Traditional Chinese Medicine between May 2020 and April 2024 were retrospectively enrolled.General patient data,laboratory parameters,and imaging findings were collected.Follow-up was conducted via outpatient visits or telephone interviews to record overall survival(OS),with the follow-up cutoff date set as April 2025.Patients were categorized into low-risk(n=81,0-2 points),intermediate-risk(n=51,3-4 points),and high-risk(n=18,5-6 points)groups based on the ADA score,and their clinical characteristics were compared.Cox proportional hazards regression model was used to identify prognostic factors.Receiver operating characteristic(ROC)curves were plotted,and the area under the curve(AUC)was calculated to evaluate the predictive value of individual indicators and the combined model for patient mortality.Results Significant differences were observed among the low-,intermediate-,and high-risk ADA score groups in terms of age,albumin(ALB),D-dimer,pre-discharge angiographic risk stratification of acute coronary syndrome(PARIS)score,and global registry of acute coronary events(GRACE)score(P<0.05).Follow-up results showed that 25 of the 150 patients died(16.67%),with a median OS of 44 months.The comparison of median OS in the low-,intermediate-,and high-risk ADA score groups showed a statistically significant difference(χ2=42.264,P<0.001).Univariate Cox analysis indicated that age,ALB,D-dimer,PARIS score,and GRACE score were associated with the prognosis of acute myocardial infarction patients undergoing PCI(P<0.05).Multivariate Cox proportional hazards regression analysis revealed that D-dimer(HR=40.351,95%CI:5.397-301.710),age(HR=1.076,95%CI:1.038-1.116),PARIS score(HR=1.692,95%CI:1.306-2.193),and GRACE score(HR=1.034,95%CI:1.003-1.065)were independent risk factors for adverse postoperative prognosis(P<0.05),while ALB was a protective factor(HR=0.861,95%CI:0.811-0.914,P<0.05).ROC curve analysis demonstrated that the combined prediction model had an AUC of 0.803(95%CI:0.730-0.863),with a sensitivity of 68.00%and a specificity of 81.60%,which was significantly higher than those of the PARIS score and GRACE score(P<0.05).Conclusion Age,ALB,D-dimer,PARIS score,and GRACE score are independent influencing factors for the prognosis of acute myocardial infarction patients after PCI.The established combined model exhibits good predictive performance and can serve as a reference tool for clinical postoperative risk stratification and individualized intervention.
Keywords：acute myocardial infarctionpercutaneous coronary interventionageD-dimeralbuminprognosis assessment
Publication Date：2025-12-20
Online Publishing Date：2025-12-25(First online date of this platform, not the publication date of the document)
Pages：6( 80-85 )