Young Adult Patients With Short Dissection Length and Thrombosed False Lumen Without Ulcer-Like Projections are Liable to Have False-Negative Results of D-Dimer Testing for Acute Aortic Dissection Based on a Study of 113 Cases

Hiroshi Hazui; Masayoshi Nishimoto; Masaaki Hoshiga; Nobuyuki Negoro; Hideyuki Muraoka; Motonobu Murai; Yasuo Ohishi; Hitoshi Fukumoto; Hiroshi Morita

doi:10.1253/circj.70.1598

Clinical Investigation

Young Adult Patients With Short Dissection Length and Thrombosed False Lumen Without Ulcer-Like Projections are Liable to Have False-Negative Results of D-Dimer Testing for Acute Aortic Dissection Based on a Study of 113 Cases

Hiroshi Hazui, Masayoshi Nishimoto, Masaaki Hoshiga, Nobuyuki Negoro, Hideyuki Muraoka, Motonobu Murai, Yasuo Ohishi, Hitoshi Fukumoto, Hiroshi Morita

Author information

Hiroshi Hazui
Department of Emergency Medi.cine, Osaka Mishima Emergency and Critical Care Center
Masayoshi Nishimoto
Department of Emergency Medi.cine, Osaka Mishima Emergency and Critical Care Center
Masaaki Hoshiga
First Department of Internal Medicine, Osaka Medical College
Nobuyuki Negoro
First Department of Internal Medicine, Osaka Medical College
Hideyuki Muraoka
Department of Emergency Medi.cine, Osaka Mishima Emergency and Critical Care Center
Motonobu Murai
Department of Emergency Medi.cine, Osaka Mishima Emergency and Critical Care Center
Yasuo Ohishi
Department of Emergency Medi.cine, Osaka Mishima Emergency and Critical Care Center
Hitoshi Fukumoto
Department of Emergency Medi.cine, Osaka Mishima Emergency and Critical Care Center
Hiroshi Morita
Department of Emergency Medi.cine, Osaka Mishima Emergency and Critical Care Center

Keywords: Acute aortic dissection, D-dimer, Dissection length, Thrombosed false lumen, Ulcer-like projection

JOURNAL FREE ACCESS

2006 Volume 70 Issue 12 Pages 1598-1601

DOI https://doi.org/10.1253/circj.70.1598

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Abstract

Background Previous reports indicate that D-dimer testing (DT) for acute aortic dissection (AAD) has a sensitivity of 100%, but each study comprised less than 30 patients. The aim of this study was to evaluate the positive rate and factors related to the results of DT for AAD in a larger population. Methods and Results DT (cutoff; upper normal limit) was performed for 113 consecutive AAD patients within 24 h of symptom onset. In total, 104 (92%) patients exhibited positive DT. The positive rate of DT showed a low tendency in patients aged less than 70 years and for a time interval from symptom onset to admission within 120 min, and there were significant differences between those with and without a thrombosed false lumen (TFL) (86.4% (n=59) vs 98.1% (n=54), p=0.033), complete TFL (excluding patients with ulcer-like projection (ULP) from those with a TFL) (81.1% (n=37) vs 97.4% (n=76), p=0.005) and length score (1 (n=28); 78.6%, 2 (n=40); 95.0%, 3 (n=45); 97.8%, p=0.005). Multivariate analysis demonstrated age (odds ratio =1.164, p=0.013), complete TFL (0.048, 0.030) and length score (6.271, 0.033) as independent factors. Conclusions Physicians should be aware that younger patients with short dissection length and a TFL without ULP are liable to have false-negative DT results. (Circ J 2006; 70: 1598 - 1601)

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