Value of D-dimer and C Reactive Protein in Predicting Inhospital Death in Acute Aortic Dissection

Study Questions:

What is the role of D-dimer and C-reactive protein (CRP) in predicting in-hospital mortality in acute aortic dissection (AD)?

Methods:

This was a single-center prospective study of 114 patients with acute AD managed at a University hospital in China. The study divided patients into groups of survival and death. Admission D-dimer and CRP were checked preoperatively.

Results:

Of 114 patients, 83 patients survived and 31 died during hospitalization. The percentage of type A AD (83.9% vs. 45.8%, p < 0.001), plasma D-dimer (9.84 ± 3.53 vs. 4.28 ± 1.99 µg/ml, p < 0.001), CRP (14.08 ± 2.81 vs. 11.18 ± 1.85 mg/L, p < 0.001) concentrations, and aortic diameter (45.2 ± 9.5 vs. 40.3 ± 6.0 mm, p = 0.007) were significantly higher in the death than in the survival group. Receiver operating characteristic analysis was used to determine the cut-off value of D-dimer and CRP in the evaluation of in-hospital mortality. The cut-off values were 5.67 µg/ml for D-dimer, and 11.21 mg/L for CRP.

Conclusions:

The authors concluded that D-dimer and CRP are independently associated with risk of in-hospital mortality in patients presenting with acute AD.

Perspective:

There is growing interest in the clinical value of D-dimer to facilitate early diagnosis (or exclusion) of acute AD. The present analysis adds to these studies by now, suggesting that in-hospital mortality is independently associated with D-dimer and CRP. Further studies should validate the role of D-dimer, CRP, and other biomarkers in predicting in-hospital prognosis following acute AD.

Keywords: Hospitals, Prognosis, Risk, C-Reactive Protein, China, Hospital Mortality, Biological Markers, Fibrin Fibrinogen Degradation Products, Early Diagnosis, ROC Curve


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