Key result
The authors argue that relying on a D-Dimer threshold <0.1 µg/mL to exclude acute aortic dissection in all cases could prove misleading.
Why the study?
Does D-Dimer measurement reliably exclude acute aortic dissection?
Does D-Dimer measurement reliably exclude acute aortic dissection?
The authors challenge the assertion that a D-Dimer threshold <0.1 µg/mL has a 100% negative predictive value for excluding acute aortic dissection.
We read with great interest the article by Sodeck et al.1 reporting the negative predictive value of D-Dimer in acute aortic dissection (AAD). Based on a meta-analysis and on a personal series of 65 patients, the authors conclude that current evidence supports a routine measurement of D-Dimer for excluding AAD. Furthermore, a D-Dimer threshold <0.1 µg/mL would exclude AAD in all cases. We previously reported on a 94-case series of patients2 and believe for several reasons that Sodeck's conclusion could prove misleading.
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Ohlmann et al. (2008) conducted a letter in Acute aortic dissection. D-Dimer measurement was evaluated on Negative predictive value of D-Dimer. The authors argue that relying on a D-Dimer threshold <0.1 µg/mL to exclude acute aortic dissection in all cases could prove misleading.
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