Lysophosphatidic Acid May Be a Novel Biomarker for Early Acute Aortic Dissection

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Emergency Medicine

Background:

• Acute aortic dissection (AAD) is associated with high mortality due to misdiagnosis and delayed diagnosis.
• Lysophosphatidic acid (LPA), a biomarker linked to coagulation and cardiovascular injury, has an unclear role in AAD diagnosis.
• The diagnostic utility of LPA in differentiating AAD from other causes of acute chest pain requires investigation.

Purpose of the Study:

• To investigate the plasma concentration of LPA in patients with suspected AAD.
• To evaluate LPA's ability to discriminate AAD from other acute chest pain conditions.
• To compare LPA's diagnostic performance against D-dimer.

Main Methods:

• Plasma LPA levels were measured in 174 patients with suspected AAD and 30 healthy controls.
• Diagnostic accuracy measures, including AUC, sensitivity, and specificity, were calculated for LPA.
• Receiver operating characteristic (ROC) curves were used to compare LPA with D-dimer.

Main Results:

• LPA concentrations were significantly higher in AAD patients compared to those with acute myocardial infarction, pulmonary embolism, and healthy individuals (P < 0.01).
• LPA levels peaked at 12 hours post-symptom onset and declined between 12 and 48 hours.
• LPA demonstrated a superior area under the ROC curve (AUC) compared to D-dimer (P = 0.041), with an AUC of 0.85, sensitivity of 0.81, and specificity of 0.77.

Conclusions:

• LPA exhibits superior diagnostic performance to D-dimer for early AAD detection.
• LPA is a potential biomarker for diagnosing acute aortic dissection.
• Further research is needed to establish rapid and cost-effective diagnostic tests utilizing LPA in emergency settings.