D-dimer in Acute Aortic Dissection

Weber, Thomas; Högler, Sonja; Auer, Johann; Baldassano, Robert N.; Laßnig, Elisabeth; Kvas, Erich; Eber, Bernd

doi:10.1378/chest.123.5.1375

Cited by 180 publications

(156 citation statements)

References 13 publications

Supporting

Mentioning

142

Contrasting

Unclassified

Order By: Relevance

“…Similarly, in patients with deep vein thrombosis, the ultrasound‐based estimated thrombus volume correlates with the D‐dimer concentration 31. These findings are consistent with the finding that D‐dimer elevation is associated with extensive aortic dissection 12, 13, 14. The insight gained from our study is that the D‐dimer concentration is related to the extent of dissection in patients with ATAAD regardless of the FL status.…”

Section: Discussionsupporting

confidence: 88%

“…Previously reported studies of the relation between serum D‐dimer concentrations and dissection morphologic features have included relatively small numbers of patients (n=24–114) and have not controlled for the time from symptom onset to hospital admission 12, 13, 14, 15. To the best of our knowledge, the study described herein is the largest to date in which the relation between D‐dimer concentrations and dissection morphologic features has been examined in patients who have undergone aortic repair for ATAAD.…”

Section: Discussionmentioning

confidence: 99%

“…The behavior of D‐dimer should be understood when the data are being interpreted. In addition to dissection morphologic features, age12 and the time between the onset of symptoms and D‐dimer testing14, 33 have been reported to influence the D‐dimer concentration. The serum D‐dimer concentration has been reported to increase within 6 hours after the onset of aortic dissection and to peak within 24 hours 20, 33.…”

Section: Discussionmentioning

confidence: 99%

“…The utility of D‐dimer assessment in the diagnosis of acute aortic syndrome, including AAD, is well recognized 6, 7, 8, 9, 10. The European Society of Cardiology Guidelines recommends D‐dimer elevation as a IIa indication for a diagnostic workup of acute aortic syndrome,11 and previously reported studies have shown correlation between D‐dimer concentrations and the extent of aortic dissection 12, 13, 14. In addition, the D‐dimer concentration is reported to be lower in patients with a thrombosed false lumen (FL) or intramural hematoma than in patients with patent‐type AAD (ie, AAD with a patent FL) 12, 15.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Itagaki

Kimura

Mieno

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundClinical characteristics and treatment outcomes of acute type A aortic dissection with D‐dimer elevation have not been clarified.Methods and ResultsD‐dimer was measured preoperatively within 24 hours of symptom onset in 262 patients with acute type A aortic dissection. The median (and interquartile range) admission D‐dimer concentration in our total patient group was 26.7 (8.3–85.9) μg/mL. Median (interquartile range) D‐dimer concentrations were 5.0 (2.6–18.0) μg/mL for complete false lumen thrombosis (n=33), 60.9 (19.4–160.4) μg/mL for partial thrombosis (n=81), 26.5 (10.0–70.6) μg/mL for a patent false lumen (n=131), and 8.7 (3.2–26.9) μg/mL for ulcerlike projection (n=17) (P<0.01). With a D‐dimer concentration of ≤8.3 μg/mL representing the lower quartile, we then investigated predictors of a low D‐dimer level. Multivariate analysis showed dissection limited to the ascending aorta (P<0.01; odds ratio, 9.81) or descending aorta (P<0.01; odds ratio, 7.68), a completely thrombosed false lumen (P<0.01; odds ratio, 4.02), and absence of brain ischemia (P=0.013; odds ratio, 4.74) to be predictors of the lower D‐dimer concentration. Compared with patients with a low D‐dimer concentration (≤8.3 μg/mL, n=66), patients with a D‐dimer concentration >8.3 μg/mL (n=196) had a reduced preoperative platelet count and increased operation time and transfusion volume. In‐hospital mortality was elevated in this group (1.5% versus 11.2%; P=0.031), although 7‐year survival did not differ for hospital survivors (lower versus higher, 93.1% versus 79.1%; P=0.21).ConclusionsD‐dimer concentrations are strongly influenced by the extent of dissection and false lumen status. Operative risks are increased in patients with a relatively high D‐dimer concentration.

show abstract

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Itagaki

Kimura

Mieno

et al. 2018

JAHA

View full text Add to dashboard Cite

show abstract

“…D-dimer is a typical degradation product of cross-linked fibrin, which is considered as the best available laboratory marker of coagulation activation, and levels have been found to correlate with the extent of thrombosis (4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

Ersel¹,

Aksay²,

Kıyan³

et al. 2010

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

Objective: To determine the diagnostic accuracy of D-dimer testing for detection of acute aortic dissection. Methods: This study is a retrospective chart review of patients who had been evaluated with suspicion of acute aortic dissection. All patients' D-dimer levels were determined prior to their further work up in the emergency department. The study was conducted in a tertiary care center between February 2006-August 2008. The D-dimer assay used was the immunoturbidimetric assay, with a normal range up to 0.246 μg/ml. Statistical analysis was accomplished using Chi-square test, Student's t-test and a receiver-operating characteristics (ROC) curve analysis. Results: Ninety-nine patients were included in the study, 30 patients were diagnosed as having acute aortic dissection and 69 patients were evaluated in non-acute aortic dissection group. In comparison of the two groups, positive D-dimer results were found to be significantly higher in acute aortic dissection group than in non-acute aortic dissection group (p<0.001). Sensitivity of the D-dimer test in detection of acute aortic dissection was found as 96.6% and the negative predictive value of the test was 97.3%. Specificity and positive predictive value of the D-dimer test were 52.2% and 46.8%, respectively. The area under the ROC curve yielded an acceptable certainty for excluding acute aortic dissection on base of negative results (AUC: 0.764; CI 95%: 0.674-0.855; p<0.001). Conclusion: D-dimer testing is helpful for emergency physicians in detection of patients with suspected acute aortic dissection in the emergency department. (Anadolu Kardiyol Derg 2010; 10: 434-9) Key words: Acute aortic dissection, D-dimer, fibrin degradation products, emergency department, diagnostic value of tests ÖZET Amaç: D-dimer testinin akut aort disseksiyonunu belirlemede tanısal değerini saptamak. Yöntemler: Bu çalışma retrospektif bir çalışmadır. Acil serviste akut aort disseksiyonu şüphesi mevcut olan ve ileri tetkik öncesi D-dimer testi istenen hastalar çalışmaya dâhil edilmiştir. 3. basamak bir sağlık kuruluşunda gerçekleştirilen çalışmada, Şubat 2006-Ağustos 2008 tarihleri arasındaki kayıtlar incelenmiştir. Kullanılan D-dimer ölçüm yöntemi immunoturbidimetrik yöntemdir ve 0.246 μg/ml'ye kadar olan sonuçlar normal olarak kabul edilmiştir. İstatistiksel analizde Ki-kare testi, Student's t-testi kullanılmış, ayrıca ROC eğrisi analizi yapılmıştır. Bulgular: Çalışmaya 30 akut aort disseksiyonu mevcut, 69 akut aort disseksiyonu mevcut olmayan kontrol grubu olmak üzere 99 hasta dâhil edilmiştir. Bu iki gruba ait D-dimer ölçümlerinin karşılaştırılmasında akut aort disseksiyonu olan hastaların olmayanlara göre istatistiksel anlamlı olarak daha fazla pozitif sonucunun olduğu görülmüştür (p<0.001). Akut aort disseksiyonunu saptamada D-dimer testinin duyarlılığı %96.6 özgünlüğü %52.2 negatif prediktif değeri %97.3 pozitif prediktif değeri ise %46.8 olarak bulunmuştur. ROC analizi sonucunda eğri altında kalan (AUC) değeri 0.764 (CI %95: 0.674-0.855) ve p<0.001) olarak saptanmı...

show abstract

Excluding Pulmonary Embolism With Computed Tomographic Pulmonary Angiography or Ventilation-Perfusion Lung Scanning

Mir¹

2008

JAMA: The Journal of the American Medical Association

View full text Add to dashboard Cite

D-dimer in Acute Aortic Dissection

Cited by 180 publications

References 13 publications

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Characteristics and Treatment Outcomes of Acute Type A Aortic Dissection With Elevated D‐Dimer Concentration

Can D-dimer testing help emergency department physicians to detect acute aortic dissections?

Excluding Pulmonary Embolism With Computed Tomographic Pulmonary Angiography or Ventilation-Perfusion Lung Scanning

Contact Info

Product

Resources

About