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Using fibrin degradation products level to facilitate diagnostic evaluation of potential acute aortic dissection

Akiyoshi Hagiwara1, Takuro Shimbo, Akio Kimira

  • 1Department of Emergency Medicine and Critical Care, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. ahagiwar@hosp.ncgm.go.jp

Journal of Thrombosis and Thrombolysis
|July 20, 2012
PubMed

Insights

Fibrin and fibrinogen degradation products (FDP) can help distinguish acute aortic dissection (AAD) from other acute conditions. Elevated FDP levels are significantly higher in AAD patients, aiding in diagnosis.

Area of Science:

  • Cardiovascular Medicine
  • Diagnostic Biomarkers
  • Emergency Medicine

Background:

  • Acute aortic dissection (AAD) requires rapid differentiation from other acute cardiovascular and cerebrovascular events.
  • Plasma fibrin and fibrinogen degradation products (FDP) are markers of fibrinolysis and may reflect disease activity.

Purpose of the Study:

  • To evaluate the utility of FDP levels in differentiating AAD from acute myocardial infarction (AMI), angina pectoris, acute cerebral infarction, and transient cerebral ischemic attack (TIA).
  • To assess FDP's effectiveness in distinguishing between patent-type and thrombosed-type AAD.

Main Methods:

  • Ninety-six AAD patients and control groups (AMI, angina, cerebral infarction, TIA) had FDP levels measured on admission.
  • AAD patients were categorized into patent-type (n=45) and thrombosed-type (n=51) false lumens.
  • Receiver operating characteristic (ROC) curve analysis was used to determine diagnostic cutoff values.

Main Results:

  • FDP levels were significantly higher in both patent-type and thrombosed-type AAD compared to control groups.
  • An FDP cutoff of ≥ 12.6 μg/mL demonstrated 100% sensitivity and 100% negative predictive value for patent-type AAD.
  • An FDP cutoff of ≥ 5.6 μg/mL showed 100% sensitivity and 100% negative predictive value for thrombosed-type AAD.
  • FDP showed a strong correlation (R²=0.95) with D-dimer levels.

Conclusions:

  • FDP levels can effectively differentiate AAD from other acute conditions, with distinct cutoffs for patent-type and thrombosed-type AAD.
  • An FDP level ≥ 12.6 μg/mL strongly suggests patent-type AAD, while ≥ 5.6 μg/mL indicates potential thrombosed-type AAD.
  • FDP serves as a valuable diagnostic biomarker in suspected AAD cases.

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