A Novel Serum Biomarker Model to Discriminate Aortic Dissection from Coronary Artery Disease

Figures

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  Figure 1. Distributions of biomarkers according to disease status and the time from symptom onset in AD patients. (a) Distributions of D-dimer according to disease status; (b) distributions of D-dimer according to the time from symptom onset in AD patients processed by the Napierian logarithm; (c–i) distributions of biomarkers associated with iron metabolism according to disease status (c) TF, (d) sFe, (e) TIBC, (f) UIBC, (g) ferritin, (h) sTFR, and (i) TFS; (j–p) distributions of biomarkers associated with iron metabolism according to the time from symptom onset in AD patients processed by the Napierian logarithm: (j) TF, (k) sFe, (l) ferritin, (m) TIBC, (n) UIBC, (o) sTFR, and (p) TFS. ∗P < 0.05; ∗∗P < 0.01; ∗∗∗P < 0.001; ∗∗∗∗P < 0.0001. AD: aortic dissection; CAD: coronary artery disease; sFe: serum iron; TF: transferrin; TIBC: total iron-binding capacity; UIBC: unsaturated iron-binding capacity; sTFR: soluble transferrin receptor; TFS: transferrin saturation.

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  Figure 2. Receiver operating characteristic curves for biomarkers according to the time from symptom onset. (a) Single factor between AD and CAD in the discovery set. (b) FLUTHE between AD and CAD patients of the discovery set in all-time intervals. (c) FLUTHE between AD and non-AD disease patients of the discovery set in all-time intervals. (d) FLUTHE between AD and CAD patients in the discovery set within the first 72 h from symptom onset. (e) FLUTHE between AD and CAD patients in the discovery set over the first 72 h from symptom onset. (f) FLUTHE between AD and non-AD patients in the discovery set within the first 72 h from symptom onset. (g) FLUTHE between AD and non-AD patients in the discovery set over the first 72 h from symptom onset. AD: aortic dissection; CAD: coronary artery disease; sFe: serum iron; TF: transferrin; TIBC: total iron-binding capacity.

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  Figure 3. Receiver operating characteristic curves of biomarkers according to the time from symptom onset. (a) FLUTHE score system between AD and CAD patients in all-time intervals. (b) The distribution of FLUTHE score system between AD and CAD patients. AD: aortic dissection; CAD: coronary artery disease.

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  Figure 4. Flowchart summarizing the diagnostic workup. For patients in the discovery and validation sets with FLUTHE score system, low possibility group includes 4 patients with AD and 36 patients with non-AD (including 30 with CAD). High possibility group includes 188 patients with AD and 23 patients with non-AD (including 11 with CAD). Medium possibility group includes 70 patients with AD and 84 patients with non-AD (including 50 with CAD). AD: aortic dissection; CAD: coronary artery disease.