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Lower circulating Sta-Liatest D-Di levels in patients with aortic intramural hematoma compared with classical aortic

Patrick Ohlmann1, Antoine Faure, Olivier Morel

  • 1Departments of Cardiac Surgery, University Hospital of Strasbourg, France. patrick.ohlmann@chru-strasbourg.fr

Critical Care Medicine
|February 25, 2009
PubMed

Insights

D-dimer levels are lower in aortic intramural hematoma (AIH) than in classic acute aortic dissection (AAD). This diagnostic test may be negative in AIH cases, requiring careful interpretation for acute aortic syndrome.

Area of Science:

  • Cardiovascular Medicine
  • Diagnostic Imaging
  • Biomarker Research

Background:

  • Acute aortic dissection (AAD) is a life-threatening condition.
  • Aortic intramural hematoma (AIH) is a variant of AAD without a patent false lumen, presenting diagnostic challenges.
  • D-dimer is a biomarker used in diagnosing thrombotic events.

Purpose of the Study:

  • To compare the diagnostic value of circulating Sta-Liatest D-Di levels in classic AAD versus AIH.
  • To evaluate the sensitivity of D-dimer testing in differentiating between AAD and AIH.
  • To assess the clinical implications of D-dimer levels in patients with acute aortic syndrome.

Main Methods:

  • Single-center retrospective case-control study.
  • Inclusion of 94 consecutive patients with confirmed AAD and D-dimer measurements.
  • D-dimer levels assayed using the Sta-Liatest D-Di immunoturbidimetric method.

Main Results:

  • Eighty-four patients (89%) had classic AAD, and ten (11%) had AIH.
  • D-dimer levels were significantly lower in AIH (median, 1230 ng/mL) compared to classic AAD (median, 9290 ng/mL; p = 0.008).
  • D-dimer test sensitivity for detecting AIH was 90%, with one AIH patient below the 400 ng/mL threshold.

Conclusions:

  • Sta-Liatest D-Di levels are lower in AIH than in AAD with a patent false lumen.
  • The D-dimer test may yield negative results in cases of intramural hematoma.
  • Clinicians must consider the possibility of negative D-dimer results when interpreting levels in patients with acute aortic syndrome.
Abstract

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