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Value of D-dimer and C reactive protein in predicting inhospital death in acute aortic dissection
  1. Dan Wen1,
  2. Xin Du1,
  3. Jian-Zeng Dong1,
  4. Xian-Liang Zhou2,
  5. Chang-Sheng Ma1
  1. 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung & Blood Vessel Diseases, Beijing, China
  2. 2Department of Cardiology, Fuwai Hospital and Cardiovascular Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  1. Correspondence to Dr Chang-Sheng Ma, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung & Blood Vessel Diseases, Beijing 100029, China; chshma{at}vip.sina.com

Abstract

Objective To evaluate the role of D-dimer and C reactive protein (CRP) in predicting inhospital death in acute aortic dissection (AD).

Design A single-centre prospective study.

Setting University hospital in China.

Patients 114 patients with acute AD.

Intervention Admission D-dimer and CRP concentrations were assayed.

Main outcome measures To observe the association of D-dimer and CRP with inhospital death.

Results Increased levels of plasma D-dimer (9.84±3.53 vs 4.28±1.99, P < 0.001), CRP (14.08±2.81 vs 11.18±1.85, P < 0.001) and aortic diameter (45.2±9.5 vs 40.3±6.0, p = 0.007) were found in dead patients compared with those survived. Moreover, plasma D-dimer concentrations in type A were higher than that in type B (6.51±4.11 vs 4.87±2.29, p = 0.013). Plasma D-dimer concentrations had positive correlations with CRP levels (r=0.527, P < 0.001) and aortic diameter (r=0.227, p = 0.015), and had negative correlations with the type of AD (r=−0.232, p = 0.013) and the time from onset (r=−0.264, p = 0.005). The type of AD, D-dimer and CRP levels and the type of AD were strongly associated with inhospital mortality. The OR and 95% CI were 3.272, 1.638 to 6.535; 2.322, 1.134 to 4.757; and 0.126, 0.019 to 0.853, respectively. Furthermore, the sensitivity and specificity of D-dimer ≥5.67 μg/mL in predicting inhospital death in acute AD were 90.3% and 75.9% (95% CI 0.85 to 0.96), respectively. Moreover, the sensitivity and specificity of CRP levels ≥11.21 mg/L were 100% and 54.2%, respectively (95% CI 0.74 to 0.89).

Conclusions D-dimer ≥5.67 μg/mL, CRP ≥11.21 mg/L and type A acute AD were important risk factors and independently associated with acute AD inhospital death.

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