Diagnostic implication of fibrin degradation products and D-dimer in aortic dissection

Dong, Jian; Duan, Xianli; Feng, Rui; Zhao, Zhi‐Qing; Xiao, Feng; Lu, Qingsheng; Jing, Qing; Zhou, Jian; Bao, Junmin; Jing, Zaiping

doi:10.1038/srep43957

Cited by 32 publications

(35 citation statements)

References 35 publications

(39 reference statements)

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“…Increased D-dimer and FDP have been reported in many diseases, including Kawasaki disease, aortic dissection, and stroke [17,7]. A strong correlation between FDP and Ddimer was also reported in many diseases [15,4,7]. Here, we also found a similar correlation between Ddimer and FDP in BP.…”

Section: Discussionsupporting

confidence: 85%

“…Increased D-dimer and FDP levels have been reported in many diseases, including deep venous thrombosis, disseminated intravascular coagulation, aortic dissection, and Crohn's disease [4,5]. BP patients are also usually in a hypercoagulable state with elevated levels of several coagulation markers, such as D-dimer and prothrombin fragment F1 + 2 [6].…”

Section: The Hypercoagulable State Is Characterized By Elevated D-dimmentioning

confidence: 99%

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Serum levels of D-dimer and fibrinogen/fibrin degradation products correlate with BP severity

Wang

Xiao

et al. 2020

Preprint

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Background Bullous pemphigoid (BP) is the most common blistering dermatosis with increasing mortality. Currently, the severity of BP can be assessed by the detection of anti-BP180 immunoglobulin G (IgG) titer, but it is absent in many grassroots clinics. BP patients are usually in a hypercoagulable state, and the levels of D-dimer and fibrin degradation products (FDPs) are elevated. Therefore, we aim to evaluate the use of D-dimer and FDPs in the assessment of BP severity. Methods This study included 33 BP and 33 Herpes zoster (HZ) patients, with the HZ patients serving as a control. The levels of plasma D-dimer and FDPs as along with eosinophil counts were recorded during a routine screening examination. Anti-BP180 IgG titer was tested by ELISA. BP lesion area was evaluated on admission. Correlational analyses were carried out between these indexes. Results The plasma D-dimer and FDP levels were higher in BP patients than in HZ patients. A significant positive correlation was found between the lesion area and both D-dimer and FDP levels in BP patients. There was also a positive association between anti-BP180 IgG and D-dimer, and between anti-BP180 IgG and FDP. Conclusions Plasma D-dimer and FDP may be convenient markers to evaluate the severity of BP.

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Section: Discussionsupporting

confidence: 85%

Section: The Hypercoagulable State Is Characterized By Elevated D-dimmentioning

confidence: 99%

Serum levels of D-dimer and fibrinogen/fibrin degradation products correlate with BP severity

Wang

Xiao

et al. 2020

Preprint

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“…Nevertheless, there is evidence that systemic inflammation characterized by elevation of the white blood cell (WBC) count [12][13][14] or an increased neutrophil/lymphocyte ratio [13,15,16] influences outcomes in patients with ATAAD. Although biomarkers of disordered coagulation and fibrinolysis D-dimer and fibrin degradation products have been well studied in relation to acute aortic dissection [17][18][19], WBC count elevation and its etiology in cases of acute aortic dissection have not been fully elucidated, and the relation between WBC elevation and dissection morphology is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Factors related to white blood cell elevation in acute type A aortic dissection

et al. 2020

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Aortic dissection may induce a systemic inflammatory reaction. The etiological backgrounds for elevation of the white blood cell count remain to be clarified. In 466 patients with acute type A aortic dissection treated surgically within 48 hours of symptom onset, the etiologic background of an elevated admission white blood cell count and the effect of such elevation on outcomes were assessed retrospectively. Patients' white blood cell count differed significantly in relation to the extent of dissection, with a median (25th, 75th percentile) white blood cell count of 10.4 (8.1, 13.9) x 10 3 /μL for dissection confined to the ascending aorta, 10.5 (8.2,13.) 10 3 /μL for dissection extending to the aortic arch/descending aorta, 11.1 (8.2, 13.7) x 10 3 /μL for extension to the abdominal aorta, and 13.3 (9.8, 15.9) x 10 3 /μL for extension to the iliac artery (p<0.001). With 11.0 x 10 3/ μL used as the cutoff value for white blood cell count elevation, multivariable analysis showed current smoking (p<0.001; odds ratio, 2.79), dissection extending to the iliac artery (p = 0.006; odds ratio, 1.79), age (p = 0.007, odds ratio, 0.98), and no coronary ischemia (p = 0.027, odds ratio, 2.22) to be factors related to the elevated white blood cell count. Mean age differed significantly between patients with and without an elevated white blood cell count (62.3 vs. 68.3 years, p <0.001). Although inhospital mortality was similar (7.5% vs.10.9%, p = 0.19), 5-year survival was lower in patients without an elevated count (85.7% vs. 78.6%, p = 0.019), reflecting their more advanced age. In conclusion, our data suggest that dissection morphology and patient age influence the acute phase systemic inflammatory response associated with an elevated white blood cell count in patients with ATAAD. A better understanding of this relation may help optimize diagnosis and perioperative care.

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“…In IgAN patients, we found no difference in the AT-level between the IgAN with T group and without T group, suggesting that the anticoagulant system was not obviously altered when the presence of brosis. D-D and FDP are the degradation product of brin, both of which re ect the brinolytic function [31]. While no difference was observed between the two groups, indicating that interstitial brosis/tubular atrophy was not accompanied by a hyper/lower activity of brinolysis.…”

Section: Discussionmentioning

confidence: 87%

Coagulation parameters are associated with the prognosis of immunoglobulin A nephropathy: a retrospective study

Xia

Liu

Peng

et al. 2020

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Background: Interstitial fibrosis/tubular atrophy (T) score is a known determinant of the progression of immunoglobulin A nephropathy (IgAN). Strong evidence indicates that the components of the coagulation system closely linked with fibrotic events and have been highlighted in the kidney. However, whether the coagulation system can affect the renal outcome of IgAN remains unclear. Herein, we investigated the association of coagulation parameters and pathological phenotype of IgAN and their combined effects on the deterioration of renal function.Methods: This retrospective study included patients with biopsy-proven IgAN from May 2009 to April 2013 in the Second Xiangya Hospital. Clinical data, pathological features were collected, and the associations of coagulation parameters at biopsy, T score, and renal outcome were evaluated. T score indicated the degree of tubular atrophy or interstitial fibrosis. The renal outcome was defined as an end-stage renal disease (ESRD) or an irreversible 50% estimated glomerular filtration rate (eGFR) reduction.Results: Shorter prothrombin time (PT) and the activated partial thromboplastin time (APTT) were significantly associated with T (both p<0.001). PT (<11.15s) or APTT (<29.65s) had worse cumulative survival rate (p=0.008, p=0.027 respectively) and were significantly but not independently associated with a higher risk of renal outcome (p=0.012, p=0.032 respectively). In the combined analyses of PT, APTT, and T lesions, the odd ratios for the outcome were significantly higher in the presence of T with PT (<11.15s) or APTT (<29.65s).Conclusion: Shorter PT and APTT are associated with an increased incidence of the T lesion and are additional factors that portend a poorer prognosis in IgAN. Monitoring coagulation function might be important when assessing the risk of progression. Additional studies exploring the molecular mechanism between coagulation and IgAN pathology are needed.

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Diagnostic implication of fibrin degradation products and D-dimer in aortic dissection

Cited by 32 publications

References 35 publications

Serum levels of D-dimer and fibrinogen/fibrin degradation products correlate with BP severity

Serum levels of D-dimer and fibrinogen/fibrin degradation products correlate with BP severity

Factors related to white blood cell elevation in acute type A aortic dissection

Coagulation parameters are associated with the prognosis of immunoglobulin A nephropathy: a retrospective study

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