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Value of plasma fibrin D-dimers for detection of acute aortic dissection
Holger Eggebrecht1, Christoph K Naber, Christian Bruch
1Department of Cardiology, West-German Heart Center Essen, University of Duisburg-Essen, Germany. holger.eggebrecht@uni-essen.de
Insights
Elevated D-dimer levels and white blood cell counts are key indicators for acute aortic dissection (AD). These biomarkers, alongside C-reactive protein, aid in diagnosing AD, distinguishing it from other chest pain causes.
Area of Science:
- Cardiovascular Medicine
- Diagnostic Biomarkers
- Inflammatory Response
Background:
- Acute aortic dissection (AD) requires rapid diagnosis and treatment.
- Currently, no specific laboratory test aids in AD diagnosis.
- Systemic inflammatory biomarkers are being investigated for diagnostic value.
Purpose of the Study:
- To evaluate the utility of systemic inflammatory biomarkers in detecting acute aortic dissection (AD).
- To assess the diagnostic value of D-dimers, white blood cell (WBC) count, C-reactive protein (CRP), and fibrinogen in AD.
Main Methods:
- Compared plasma D-dimers, WBC count, CRP, and fibrinogen in 64 chest-pain patients.
- Included groups: acute AD, pulmonary embolism (PE), acute myocardial infarction (AMI), and non-cardiac chest pain (CP).
- Used 32 asymptomatic chronic AD patients as a control group.
Main Results:
- Acute AD patients exhibited significantly elevated D-dimer levels, comparable to PE patients but higher than other groups.
- White blood cell (WBC) count was significantly increased in acute AD compared to all other groups.
- C-reactive protein (CRP) levels were elevated in acute AD, with no significant difference from PE patients. Fibrinogen levels showed no significant group differences.
Conclusions:
- D-dimer levels are significantly elevated in both acute aortic dissection (AD) and pulmonary embolism (PE).
- Acute AD is associated with notable systemic inflammatory reactions.
- Measuring D-dimers can be a valuable adjunct to the diagnostic work-up for suspected AD.
Objectives:
The purpose of this research was to assess the value of systemic inflammatory biomarkers in the detection of acute aortic dissection (AD).
Background:
Rapid diagnosis and initiation of treatment is pivotal for patients with acute AD. So far, there is no laboratory test to aid the diagnosis.
Methods:
Plasma fibrin D-dimers, white blood cell (WBC) count, C-reactive protein (CRP), and fibrinogen were determined in 64 chest-pain (CP) patients (acute AD, n = 16; pulmonary embolism [PE], n = 16; acute myocardial infarction [AMI], n = 16; non-cardiac CP, n = 16); 32 asymptomatic patients with chronic AD served as a control group.
Results:
All acute AD patients showed highly elevated D-dimer values that were similar to PE patients (2,238 +/- 1,765 microg/l vs. 1,531 +/- 837 microg/l, p = 0.15) but significantly higher than in chronic AD, AMI, or CP patients (p < 0.001). The WBC count was significantly increased in patients with acute AD compared with the other groups (p < 0.001); in addition, CRP values differed only non-significantly from PE patients(p = 0.71). There were no differences in the fibrinogen levels between the groups.
Conclusions:
D-dimers are highly elevated in both acute PE and acute AD. Patients with acute AD show significant systemic inflammatory reactions. Measurement of D-dimers may be a valuable addition to the current diagnostic work-up of patients with suspected AD.
