July 10, 2015European Heart Journal Acute Cardiovascular Care
Diagnostic role and prognostic implications of D-dimer in different classes of acute aortic syndromes
Key result
High in-hospital D-dimer linked to ~460% higher mortality risk in acute aortic syndromes.
- OR 5.60
- P=0.022
- n=522
Why the study?
The diagnostic role and prognostic value of D-dimer in patients with intramural hematoma or penetrating aortic ulcer were unknown.
Does D-dimer measurement accurately diagnose acute aortic syndrome subtypes and predict mortality in patients presenting with suspected acute aortic syndrome?
Population
231 patients with acute aortic syndrome and 291 control patients without AAS
Comparison
D-dimer measurement at admission and during hospitalization vs control patients without AAS; D-dimer ≥9.0 mg/L vs <9.0 mg/L
Design
Observational cohort study
Follow-up
In-hospital and 3 years
Authors
Discussion
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Member takes
Implication
May support D-dimer for diagnosis and risk stratification in acute aortic syndrome; leaves open prospective validation before practice change.
Study Design
Type
Observational (n=522)
Structured PICO
Does D-dimer measurement accurately diagnose acute aortic syndrome subtypes and predict mortality in patients presenting with suspected acute aortic syndrome?
P
Population
522 patients, comprising 231 with acute aortic syndromes and 291 controls, evaluated for the diagnostic and prognostic utility of D-dimer levels.
E
Exposure
D-dimer measurement at admission and during hospitalization
C
Comparator
Control patients without acute aortic syndrome (for diagnostic evaluation); D-dimer <9.0 mg/L (for prognostic evaluation)
O
Outcome
Diagnostic accuracy for acute aortic syndrome subtypes and in-hospital mortalityhard clinical
Main Result
Odds Ratio: 5.6
p-value: p=0.022
D-dimer is highly sensitive for diagnosing acute aortic dissection and intramural hematoma but not penetrating aortic ulcer, and significantly elevated in-hospital levels predict short-term mortality.
Cite This Study
Gorla et al. (2015) conducted an observational in Acute aortic syndromes (n=522). D-dimer levels vs. Controls without AAS or lower D-dimer levels was evaluated on In-hospital mortality (OR 5.60, p=0.022). In-hospital D-dimer levels ≥9 mg/L independently predicted in-hospital mortality (OR 5.60, p=0.022), while a 0.5 mg/L cutoff was highly sensitive for diagnosing AAD and IMH.