Value of plasma fibrin D-dimers for detection of acute aortic dissection

J Am Coll Cardiol. 2004 Aug 18;44(4):804-9. doi: 10.1016/j.jacc.2004.04.053.

Abstract

Objectives: The purpose of this research was to assess the value of systemic inflammatory biomarkers in the detection of acute aortic dissection (AD).

Background: Rapid diagnosis and initiation of treatment is pivotal for patients with acute AD. So far, there is no laboratory test to aid the diagnosis.

Methods: Plasma fibrin D-dimers, white blood cell (WBC) count, C-reactive protein (CRP), and fibrinogen were determined in 64 chest-pain (CP) patients (acute AD, n = 16; pulmonary embolism [PE], n = 16; acute myocardial infarction [AMI], n = 16; non-cardiac CP, n = 16); 32 asymptomatic patients with chronic AD served as a control group.

Results: All acute AD patients showed highly elevated D-dimer values that were similar to PE patients (2,238 +/- 1,765 microg/l vs. 1,531 +/- 837 microg/l, p = 0.15) but significantly higher than in chronic AD, AMI, or CP patients (p < 0.001). The WBC count was significantly increased in patients with acute AD compared with the other groups (p < 0.001); in addition, CRP values differed only non-significantly from PE patients(p = 0.71). There were no differences in the fibrinogen levels between the groups.

Conclusions: D-dimers are highly elevated in both acute PE and acute AD. Patients with acute AD show significant systemic inflammatory reactions. Measurement of D-dimers may be a valuable addition to the current diagnostic work-up of patients with suspected AD.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Dissecting / blood
  • Aneurysm, Dissecting / diagnosis*
  • Aneurysm, Dissecting / mortality
  • Aortic Aneurysm / blood
  • Aortic Aneurysm / diagnosis*
  • Aortic Aneurysm / mortality
  • Biomarkers
  • C-Reactive Protein / analysis
  • Case-Control Studies
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Fibrinogen / analysis*
  • Germany / epidemiology
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Predictive Value of Tests
  • ROC Curve

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D
  • Fibrinogen
  • C-Reactive Protein