Clinical significance of D-dimer in rapid screening for acute aortic dissection

Abstract

Objective To investigate clinical significance of D-dimer and other easily-obtained laboratory parameters in rapid screening for acute aortic dissection ( AAD). Methods Data of general health, clinical symptoms, white blood cell (WBC) count, serum levels of C-reactive protein (CRP),cardiac troponin Ⅰ (cTn Ⅰ ) and D-dimer in patients with confirmed AAD and acute coronary syndrome (ACS) were retrospectively analyzed. Significance of varied parameters in clinical diagnosis for AAD was evaluated by logistic regression model and their diagnostic values were evaluated by receiver operating characteristics (ROC) curve. Results Serum level of D-dimer increased significantly in patients with type Ⅰ AAD, as compared with that in those with type Ⅱ and type Ⅲ (P = 0. 111 and 0. 002, respectively). D-dimer, WBC and CRP all were independent risk factors for type Ⅰ AAD by logistic regression model fitted,with the largest effect of D-dimer. Analysis by ROC curve with sensitivities and specificities of serum levels of D-dimer and CRP, and WBC count also showed the same results. Conclusions Determination of serum level of D-dimer had significantly diagnostic value for AAD, and can be sued as rapid screening for it if combined with determinations of WBC and CRP. Key words: Aortic diseases ; Diagnosis ; D-dimer ;