Abstract: Abstract: Objective To investigate the value of hypersensitive C reactive protein (hs-CRP)-D-dimer, a combined indicator of hs-CRP and D-dimer, in predicting the occurrence of subacute stent thrombosis (SST) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods Patients (n=9 261) undergoing PCI for AMI from January 2012 to January 2018 were enrolled in this study. Patients with postoperative SST were selected as SST group (n=72), and patients without SST were selected as control group (n=210) according to their age and sex ratio. Data of coronary heart disease risk factors (sex, age, body mass index, etc.), clinical data［systolic blood pressure, diastolic blood pressure, creatine kinase (CK), creatine kinase isoenzyme (CK-MB)］, results of angiography (disease vessels, stent malapposition) were compared between two groups. The index of P<0.1 in general data comparison was included in multivariate logistic regression analysis. ROC curves were used to analyze hs-CRP and D-dimer, and both hs-CRP and D dimer were assessed for the predictive value of SST. Results The postoperative D-dimer, hs-CRP, glucose, stent malapposition, and number of stents were significantly higher in the SST group than those in the control group. The left ventricular ejection fraction (LVEF) was significantly lower in the SST group than that in the control group (P＜0.05). Multivariate logistic regression analysis showed that the elevated D-dimer, hs-CRP and glucose, stent malapposition were independent risk factors for SST. LVEF ＞ 0.50 was a protective factor for SST. The combined index of hs-CRP and D dimer for hs-CRP-D-dimer was 0.875 under ROC curve, 14.28 for SST, with sensitivity of 77.8% and specificity of 80.5%. Conclusion D-dimer, hs-CRP, the elevated blood glucose and stent malapposition are independent risk factors for SST, LVEF>0.50 is a protective factor for SST. Hs-CRP-D-dimer, a combined diagnostic index of hs-CRP and D-dimer, is an ideal indicator for predicting the occurrence of SST after PCI in AMI patients, and which is worthy of clinical application.

Key words: myocardial infarction, angioplasty, transluminal, percutaneous coronary, C-reactive protein, D-dimer, subacute stent thrombosis