Key result
Admission C-reactive protein was an independent predictor of in-hospital mortality in patients with type A acute aortic dissection (OR 7.06; 95% CI 1.34-37.36).
Why the study?
Does admission CRP improve risk prediction for in-hospital mortality beyond the IRAD score in patients with type A acute aortic dissection?
Cohort (n=54)
Does admission CRP improve risk prediction for in-hospital mortality beyond the IRAD score in patients with type A acute aortic dissection?
Odds Ratio: 7.06 (95% CI 1.34–37.36)
Admission CRP is an independent predictor of in-hospital mortality in type A acute aortic dissection and improves the discriminative capacity of the IRAD score.
May support CRP-augmented risk models in type A aortic dissection; leaves open prospective validation beyond IRAD.
BACKGROUND: The aim of the study was to evaluate prognostic role of inflammatory biomarkers, cardiac troponin T (cTnT) and D-dimer in type A acute aortic dissection (AAD) and to examine whether they might help in risk stratification beyond values of International Registry of Acute Aortic Dissection (IRAD) score. METHODS: Baseline biomarkers were determined in 54 consecutive predominantly hypertensive patients with type A AAD and evaluated for in-hospital mortality. RESULTS: After multivariable adjustment, the independent predictors of outcome were age (OR = 1.09; 95% CI 1.02-1.18), treatment strategy (OR = 0.11; 95% CI 0.02-0.06) and C-reactive protein (CRP) either as binary (OR = 7.06; 95% CI 1.34-37.36) or continuous variable (OR = 1.10; 95% CI 1.01-1.21). cTnT did not independently influence mortality. Receiver- operating characteristic (ROC) curve analysis showed significant link between CRP and outcome (area under the ROC curve, AUC = 0.79; p < 0.01). Values of CRP > 9.8 mg/l had 83% sensitivity and 80% specificity for predicting in-hospital mortality. Addition of CRP to IRAD score improved prediction of short-term outcome, AUC increased from 0.74 to 0.89 (p = 0.004). CONCLUSION: Admission CRP has independent prognostic value in type A AAD and the addition of CRP to IRAD score improved discriminative capacity of in-hospital mortality irrespective of symptom duration and treatment strategy.
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Vrsalović et al. (2015) conducted a cohort in Type A acute aortic dissection (n=54). C-reactive protein (CRP) was evaluated on In-hospital mortality (OR 7.06, 95% CI 1.34-37.36). Admission C-reactive protein was an independent predictor of in-hospital mortality in patients with type A acute aortic dissection (OR 7.06; 95% CI 1.34-37.36).
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