Diagnosis of acute aortic dissection by D-dimer: the International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) experience. Academic Article Article uri icon

Overview

MeSH

  • Adolescent
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Registries
  • Young Adult

MeSH Major

  • Aneurysm, Dissecting
  • Aortic Aneurysm, Thoracic
  • Diagnostic Techniques, Cardiovascular
  • Fibrin Fibrinogen Degradation Products

abstract

  • D-dimer has been reported to be elevated in acute aortic dissection. Potential use as a "rule-out" marker has been suggested, but concerns remain given that it is elevated in other acute chest diseases, including pulmonary embolism and ischemic heart disease. We evaluated the diagnostic performance of D-dimer testing in a study population of patients with suspected aortic dissection. In this prospective multicenter study, 220 patients with initial suspicion of having acute aortic dissection were enrolled, of whom 87 were diagnosed with acute aortic dissection and 133 with other final diagnoses, including myocardial infarction, angina, pulmonary embolism, and other uncertain diagnoses. D-dimer was markedly elevated in patients with acute aortic dissection. Analysis according to control disease, type of dissection, and time course showed that the widely used cutoff level of 500 ng/mL for ruling out pulmonary embolism also can reliably rule out aortic dissection, with a negative likelihood ratio of 0.07 throughout the first 24 hours. D-dimer levels may be useful in risk stratifying patients with suspected aortic dissection to rule out aortic dissection if used within the first 24 hours after symptom onset.

publication date

  • May 26, 2009

has subject area

  • Adolescent
  • Aged
  • Aged, 80 and over
  • Aneurysm, Dissecting
  • Aortic Aneurysm, Thoracic
  • Biomarkers
  • Diagnostic Techniques, Cardiovascular
  • Female
  • Fibrin Fibrinogen Degradation Products
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Registries
  • Young Adult

Research

keywords

  • Evaluation Studies
  • Journal Article
  • Multicenter Study

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1161/CIRCULATIONAHA.108.833004

PubMed ID

  • 19433758

Additional Document Info

start page

  • 2702

end page

  • 2707

volume

  • 119

number

  • 20