Evaluation of D-Dimer as a Diagnostic Tool in Patients with Acute Aortic Dissection

• 作者: Samir Rafla Tarek Bishay
• 来源期刊: 心血管病(英文)
• 学科: 医学
• 关键词: Aortic Dissection D-DIMER
• 年，卷（期）: 2021,（2）
• 页码范围: 135-144
• 页数: 10页
• 分类号: R54

摘要

Acute (Ac.) Aortic Dissection (AD) is a life threatening cardiovascular emergency. The diagnostic methods (e.g., TEE, MRI, Multislice CT) are limited by availability. A fast, cost effective and technically simple method for diagnosis of AAD is needed. D-Dimer is a measure of clot formation and lysis. The aim of this study was to determine whether assessing D-Dimer level can be used for the diagnosis of AAD. <b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> 45 patients with clinical suspicion of AAD who presented within the first 24 hours from symptom onset were studied prospectively. 20 patients were proved to have AAD by TEE (group I). The other 25 patients had other final diagnosis (group II). All the 20 patients in group I (100%) with confirmed AAD had positive and elevated D-Dimer levels while only 9 patients in group II (36%) had positive D-Dimer levels (p < 0.001). Mean D-Dimer level was significantly higher in the 20 patients in group I than in the 9 patients with positive test in group II (p < 0.01). The sensitivity of D-Dimer was 100% and the specificity was 64% for the diagnosis of AAD. Mean D-Dimer level was significantly higher in Stanford type A, AAD than in Stanford type B, AAD, (p < 0.01). 5 patients (25%) died during the in–hospital course. Mean D-Dimer level was higher in the patients who died. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> D-Dimer levels are positive and elevated in all the patients with AAD presenting within the first 24 hours from symptom onset</span><span style="font-family:Verdana;">.</span>