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Evaluation of D-dimer in the diagnosis of suspected aortic dissection

Qing-kun Fan1, Wen-wu Wang, Zhen-lu Zhang

  • 1Center of Clinical Laboratory, Wuhan Asia Heart Hospital, Wuhan, P.R. China. fanqingkun@hotmail.com

Clinical Chemistry and Laboratory Medicine
|August 14, 2010
PubMed

Insights

Plasma D-dimer shows high sensitivity for diagnosing aortic dissection (AD), but cannot rule it out completely. Further imaging is needed for patients with negative D-dimer results.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Diagnostic Markers

Background:

  • Aortic dissection (AD) is a life-threatening condition requiring rapid diagnosis.
  • Plasma D-dimer is a potential biomarker for excluding AD, but its utility requires further evaluation.

Purpose of the Study:

  • To assess the diagnostic accuracy of plasma D-dimer for the exclusion of suspected aortic dissection (AD).

Main Methods:

  • Enrolled 260 patients with suspected AD, including acute AD, chronic AD, acute myocardial infarction (AMI), pulmonary embolism (PE), non-ST elevation myocardial infarction (NSTEMI), and unstable angina (UA).
  • Performed D-dimer testing on all patients upon admission using Roche Diagnostics assays.

Main Results:

  • D-dimer levels were significantly elevated in acute AD and chronic AD groups compared to AMI, NSTEMI, and UA groups (p=0.000).
  • D-dimer levels were not significantly different between AD and PE groups.
  • One acute AD patient (0.8%) presented with a low D-dimer value, later confirmed as intramural hematoma via CT.

Conclusions:

  • Plasma D-dimer demonstrates high sensitivity (up to 99.2%) for suspected AD, suggesting its potential as a diagnostic marker.
  • D-dimer testing alone cannot achieve 100% sensitivity for AD diagnosis.
  • Imaging modalities remain essential for diagnosing suspected AD in patients with negative D-dimer results.
Abstract

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