Key result
Admission D-dimer testing at a cutoff of < 0.5 µg/ml effectively ruled out acute aortic dissection with a sensitivity of 94.0% and a negative predictive value of 96.6%.
Why the study?
Does admission D-dimer testing differentiate acute aortic dissection from other causes of acute chest pain in patients presenting within 24 hours of symptom onset?
Population
790 consecutive patients admitted for acute chest pain within 24 hours from symptom onset, including 202…
Design
Cohort
Authors
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May support D-dimer rule-out in acute chest pain cohorts; leaves open prospective validation before practice change.
Cohort (n=790)
No
Does admission D-dimer testing differentiate acute aortic dissection from other causes of acute chest pain in patients presenting within 24 hours of symptom onset?
Effect estimate: AUC 0.90 (95% CI 0.87-0.93)
A D-dimer level < 0.5 µg/ml is a highly sensitive test with a strong negative predictive value for ruling out acute aortic dissection in patients presenting with acute chest pain, though its specificity is low.
Li et al. (2017) conducted a cohort in Acute chest pain (n=790). Admission D-dimer testing vs. Non-AAD causes of acute chest pain was evaluated on Prediction of acute aortic dissection (AAD) versus non-AAD (AUC 0.90, 95% CI 0.87-0.93). Admission D-dimer testing at a cutoff of < 0.5 µg/ml effectively ruled out acute aortic dissection with a sensitivity of 94.0% and a negative predictive value of 96.6%.
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