AORTIC DISSECTION
Value of plasma fibrin D-dimers for detection of acute aortic dissection
Holger Eggebrecht, MD*,*,
Christoph K. Naber, MD*,
Christian Bruch, MD ,
Knut Kröger, MD ,
Clemens von Birgelen, MD, PhD||,
Axel Schmermund, MD*,
Marc Wichert, MD ,
Thomas Bartel, MD*,
Klaus Mann, MD and
Raimund Erbel, MD, FACC*
* Department of Cardiology
Department of Angiology
Department of Clinical Chemistry, West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany
Department of Cardiology and Angiology, University of Münster, Münster, Germany
|| Department of Cardiology, Medisch Spectrum Twente, Enschede, the Netherlands
Manuscript received March 13, 2004;
revised manuscript received April 13, 2004,
accepted April 20, 2004.
* Reprint requests and correspondence: Dr. Holger Eggebrecht, Department of Cardiology, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany (Email: holger.eggebrecht{at}uni-essen.de).
OBJECTIVES: The purpose of this research was to assess the value of systemic inflammatory biomarkers in the detection of acute aortic dissection (AD).
BACKGROUND: Rapid diagnosis and initiation of treatment is pivotal for patients with acute AD. So far, there is no laboratory test to aid the diagnosis.
METHODS: Plasma fibrin D-dimers, white blood cell (WBC) count, C-reactive protein (CRP), and fibrinogen were determined in 64 chest-pain (CP) patients (acute AD, n = 16; pulmonary embolism [PE], n = 16; acute myocardial infarction [AMI], n = 16; non-cardiac CP, n = 16); 32 asymptomatic patients with chronic AD served as a control group.
RESULTS: All acute AD patients showed highly elevated D-dimer values that were similar to PE patients (2,238 ± 1,765 µg/l vs. 1,531 ± 837 µg/l, p = 0.15) but significantly higher than in chronic AD, AMI, or CP patients (p < 0.001). The WBC count was significantly increased in patients with acute AD compared with the other groups (p < 0.001); in addition, CRP values differed only non-significantly from PE patients(p = 0.71). There were no differences in the fibrinogen levels between the groups.
CONCLUSIONS: D-dimers are highly elevated in both acute PE and acute AD. Patients with acute AD show significant systemic inflammatory reactions. Measurement of D-dimers may be a valuable addition to the current diagnostic work-up of patients with suspected AD.
|
Abbreviations and Acronyms
| | AD = aortic dissection | | AMI = acute myocardial infarction | | CP = chest pain | | CRP = C-reactive protein | | CT = computed tomography | | FL = false lumen | | PE = pulmonary embolism | | WBC = white blood cell |
|
This article has been cited by other articles:
|
|
|
|
 
I Vilacosta, P Aragoncillo, V Canadas, J A San Roman, J Ferreiros, and E Rodriguez
Acute aortic syndrome: a new look at an old conundrum
Heart,
July 15, 2009;
95(14):
1130 - 1139.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Suzuki, A. Distante, A. Zizza, S. Trimarchi, M. Villani, J. A. Salerno Uriarte, L. De Luca Tupputi Schinosa, A. Renzulli, F. Sabino, R. Nowak, et al.
Diagnosis of Acute Aortic Dissection by D-Dimer: The International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) Experience
Circulation,
May 26, 2009;
119(20):
2702 - 2707.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H Kuehl, H Eggebrecht, T Boes, G Antoch, S Rosenbaum, S Ladd, A Bockisch, J Barkhausen, and R Erbel
Detection of inflammation in patients with acute aortic syndrome: comparison of FDG-PET/CT imaging and serological markers of inflammation
Heart,
November 1, 2008;
94(11):
1472 - 1477.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
EMQ answers
Emerg. Med. J.,
February 1, 2008;
25(2):
121 - 121.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Sodeck, H. Domanovits, M. Schillinger, M. P. Ehrlich, G. Endler, H. Herkner, and A. Laggner
D-dimer in ruling out acute aortic dissection: a systematic review and prospective cohort study
Eur. Heart J.,
December 2, 2007;
28(24):
3067 - 3075.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Habara, K. Dote, M. Kato, S. Sasaki, K. Goto, H. Takemoto, D. Hasegawa, and O. Matsuda
Prediction of left atrial appendage thrombi in non-valvular atrial fibrillation
Eur. Heart J.,
September 2, 2007;
28(18):
2217 - 2222.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. T. Tsai, A. Evangelista, C. A. Nienaber, T. Myrmel, G. Meinhardt, J. V. Cooper, D. E. Smith, T. Suzuki, R. Fattori, A. Llovet, et al.
Partial Thrombosis of the False Lumen in Patients with Acute Type B Aortic Dissection
N. Engl. J. Med.,
July 26, 2007;
357(4):
349 - 359.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Ince and C. A Nienaber
Diagnosis and management of patients with aortic dissection
Heart,
February 1, 2007;
93(2):
266 - 270.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T Weber, M Rammer, J Auer, E Maurer, G Aspock, and B Eber
Plasma concentrations of D-dimer predict mortality in acute type A aortic dissection.
Heart,
June 1, 2006;
92(6):
836 - 837.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F F Immer
Is there a place for D-dimers in acute type A aortic dissection?
Heart,
June 1, 2006;
92(6):
727 - 728.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. T. Tsai, C. A. Nienaber, and K. A. Eagle
Acute Aortic Syndromes
Circulation,
December 13, 2005;
112(24):
3802 - 3813.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D-Dimer Levels Are Elevated in Acute Aortic Dissection
Journal Watch Emergency Medicine,
October 13, 2004;
2004(1013):
7 - 7.
[Full Text]
|
|
|
|
