Study on the Relationship Between Plasma D-Dimer and Prognosis in Elderly Patients with Acute Decompensated Heart Failure

YANG Jie; CAI Wenyu; ZHANG Dengqing

doi:10.13919/j.issn.2095-6274.ZHJY202504001

Abstract：Objective To explore the relationship between plasma D-dimer levels and prognosis in elderly patients with acute decompensated heart failure(ADHF).Methods This study is a single-center retrospective observational study.A total of 382 patients aged 75 years and older with ADHF who were admitted to Jinjiang Hos-pital between January 2021 and November 2024 were included.The median follow-up time was 16 months(range:1.15 to 34 months).The study aimed to investigate the association between plasma D-dimer levels and all-cause mortality.The optimal cutoff value for D-dimer was determined to be 0.7 μg/ml based on the receiver operating characteristic(ROC)curve analysis,dividing patients into a low group(≤ 0.7 μg/ml,133 cases)and a high group(＞0.7 μg/ml,249 cases).Baseline characteristics between the two groups were compared,and Cox proportional hazards models were used to assess whether D-dimer levels were an independent risk factor for all-cause mortal-ity.Results In this study,138 deaths were observed,with 92 occurring in the hospital.Plasma D-dimer levels＞0.7 μg/ml were independent predictors of in-hospital mortality(HR=1.572,95％CI:1.330～1.992,P=0.047)and overall all-cause mortality(HR=1.643,95％CI:1.419～1.985,P=0.043).The sensitivity(0.783)and specificity(0.578)of high D-dimer levels for predicting overall all-cause mortality were higher than those for in-hos-pital all-cause mortality(sensitivity=0.643,specifici-ty=0.531).Conclusion Plasma D-dimer levels are independent predictors of in-hospital and overall all-cause mortality in elderly patients with acute heart fail-ure.D-dimer levels＞0.7 μg/ml effectively predict the risk of death in these patients.