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Novel Blood Biomarkers for a Diagnostic Workup of Acute Aortic Dissection

Anja Forrer1, Felix Schoenrath2,3, Michael Torzewski4

  • 1Institute of Clinical Chemistry, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland.

Diagnostics (Basel, Switzerland)
|April 3, 2021
PubMed

Insights

Researchers identified potential blood biomarkers for acute aortic dissection (AAD). Interleukin-10 (IL-10) shows promise as a rule-in biomarker, while a combination of D-dimers, hs-TnT, IL-6, and PAI1 improves diagnosis accuracy.

Area of Science:

  • Biochemistry
  • Cardiovascular Medicine
  • Medical Diagnostics

Background:

  • Acute aortic dissection (AAD) is a life-threatening cause of chest pain, lacking specific diagnostic blood tests.
  • Differential diagnosis of acute chest pain often involves acute myocardial infarction (AMI) and pulmonary embolism (PE).

Purpose of the Study:

  • To identify novel plasma biomarkers for the diagnosis of acute aortic dissection (AAD).
  • To evaluate the diagnostic performance of identified biomarkers, individually and in combination, for AAD.

Main Methods:

  • Proseek® Multiplex assays were used to screen plasma samples from patients with AAD, AMI, PE, thoracic aortic aneurysm (TAA), and non-cardiovascular chest pain (nonCVD).
  • Top candidate biomarkers were validated using conventional immunoassays and their expression analyzed in aortic tissue.

Main Results:

  • Interleukin-10 (IL-10) demonstrated high specificity (98%) and moderate sensitivity (55%) for AAD diagnosis.
  • A panel including D-dimers, high-sensitive troponin T (hs-TnT), interleukin-6 (IL-6), and plasminogen activator inhibitor 1 (PAI1) achieved 83% sensitivity and 95% specificity for AAD detection.
  • This biomarker combination correctly classified 77% of all patient cases.

Conclusions:

  • IL-10 presents potential as a specific rule-in biomarker for AAD.
  • Combining IL-6 and PAI1 with hs-TnT and D-dimers may enhance the differentiation of AAD from other acute chest pain causes like AMI and PE.

Keywords:
D-dimersIL-10acute aortic dissectionacute myocardial infarctionbiomarkerpulmonary embolism

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