Related Experiment Video
Updated: Aug 9, 2026
Measurement of Pulse Propagation Velocity, Distensibility and Strain in an Abdominal Aortic Aneurysm Mouse Model
Published on: February 23, 2020
Diagnostic and prognostic value of circulating D-Dimers in patients with acute aortic dissection
Patrick Ohlmann1, Antoine Faure, Olivier Morel
1Fédération of cardiologie, Service de chirurgie cardiaque, Hôpitaux Universitaires de Strasbourg, France.
Insights
Elevated D-Dimer levels are highly indicative of acute aortic dissection (AAD), offering valuable diagnostic and prognostic insights. Consider AAD in patients with chest pain and high D-Dimer, as it aids in diagnosis.
Area of Science:
- Cardiology
- Vascular Surgery
- Emergency Medicine
Background:
- Acute aortic dissection (AAD) is a life-threatening condition requiring prompt diagnosis.
- Current diagnostic methods can be invasive or have limitations.
- The role of D-Dimer in AAD management needs further clarification.
Purpose of the Study:
- To evaluate the diagnostic and prognostic utility of D-Dimer testing in patients with suspected acute aortic dissection.
- To assess the correlation between D-Dimer levels and disease severity or outcomes in AAD patients.
Main Methods:
- Retrospective case-control study at a single university hospital.
- Included 94 patients with confirmed AAD and 94 controls with suspected but ruled-out dissection.
- Analyzed patient characteristics, D-Dimer levels, and clinical course.
Main Results:
- 99% of AAD patients had elevated D-Dimer (>400 ng/mL), with a median of 8610 ng/mL.
- D-Dimer was a strong predictor of AAD (99% sensitivity, 34% specificity).
- Elevated D-Dimer correlated with dissection extension and in-hospital mortality.
Conclusions:
- D-Dimer levels are significantly elevated in AAD and provide crucial diagnostic and prognostic information.
- High D-Dimer in patients with chest pain warrants consideration of AAD.
- D-Dimer serves as a valuable complementary tool in the diagnostic work-up for suspected AAD.
Objective:
We sought to determine whether assessing D-Dimer might be helpful for the management of acute aortic dissection (AAD).
Design:
Single-center retrospective case-control study.
Setting:
University Hospital of Strasbourg France.
Patients:
Patients were 94 consecutive patients admitted to our institution with confirmed AAD and in whom D-Dimer test had been performed at presentation. These patients were matched with 94 controls presenting with clinical suspicion of dissection, which was later ruled out.
Interventions:
Patient characteristics and clinical course were analyzed.
Measurements And Main Results:
Ninety-three (99%) patients with AAD had elevated D-Dimer (>400 ng/mL) with a median D-Dimer value of 8610 ng/mL (interquartile range, 2982-20,000 ng/mL). Receiver operating characteristic curves analysis showed that D-Dimer, but not C-reactive protein, troponin, lactate dehydrogenase, or leukocyte count, was predictive of a diagnosis of AAD, with a sensitivity and specificity of 99% and 34%, respectively. D-Dimer concentration positively correlated with the anatomical extension of the dissection to the different segments of the aorta (R = .47, p < .0001). A positive relationship was observed between D-Dimer and in-hospital mortality rate among patients with AAD (p = .037). On multivariate analysis, the independent predictors of in-hospital mortality were the presence of pericardial effusion (odds ratio, 6.80; confidence interval, 1.87-27.60), D-Dimer >5200 ng/mL (odds ratio, 5.38; confidence interval, 1.27-30.87), and female gender (odds ratio, 4.96; confidence interval, 1.39-19.95).
Conclusions:
D-Dimers are elevated in patients with AAD and provide valuable diagnostic and prognostic information. In patients with acute chest pain and elevated D-Dimer, a diagnosis of AAD should also be considered. D-Dimer might be a useful complementary tool to the current diagnostic work-up of patients with suspected AAD.
Related Concept Videos
01:22Aortic Regurgitation II: Clinical Features and Diagnostic Tests
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...