The diagnostic and prognostic value of D-dimer in different types of aortic dissection

J Cardiothorac Surg. 2022 Aug 20;17(1):194. doi: 10.1186/s13019-022-01940-5.

Abstract

Objective: To evaluate the serum D-dimer level and its diagnostic and prognostic predictive value in patients with different types of aortic dissection.

Methods: Eighty-four aortic dissection patients who were diagnosed clinically in our hospital from January 2017 to January 2021 were selected for the study. All patients were divided into Stanford type A (39 cases) and Stanford type B (45 cases) groups. The serum D-dimer level was detected at 1 h, 6 h, 12 h, 24 h, and 72 h after admission to the hospital, and its expression level with different types of aortic dissection was analyzed. The relationship between D-dimer and the prognosis of patients was also analyzed.

Results: The serum D-dimer levels of patients in group A were significantly higher than those in group B at 6 h, 12 h, 24 h, and 72 h after admission, and the differences were statistically significant. In group A, 16 patients died, and 23 patients survived, while in group B, 18 patients died, and 27 patients survived. The serum D-dimer level of the dead and surviving patients in group A was significantly higher than that of group B, and the serum D-dimer level of dead patients in groups A and B was significantly higher than that of surviving patients. For diagnostic value, the AUC was 0.89, sensitivity was 76.92%, specificity was 90.00% in group A, and the AUC was 0.82, sensitivity was 71.11%, and specificity was 85.00% in group B. For the prognostic predicted value, the AUC was 0.74 in group A, while the AUC was 0.69 in group B.

Conclusions: D-dimer has different serum levels in different types of aortic dissection patients, with higher levels in Stanford A. Serum D-dimer levels may be used as a better biomarker to diagnose the two types of aortic dissection and play an important role in patient prognostic prediction, especially Stanford type A.

Keywords: Aortic dissection; Biomarker; D-dimer; Diagnostic; Prognostic.

MeSH terms

  • Aortic Aneurysm* / diagnosis
  • Aortic Dissection* / diagnosis
  • Biomarkers
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Prognosis
  • Retrospective Studies

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D