Impact of a negative D-dimer result on the initial assessment of acute aortic dissection.
Int J Cardiol
; 258: 232-236, 2018 05 01.
Article
em En
| MEDLINE
| ID: mdl-29422267
ABSTRACT
BACKGROUND:
D-dimer shows high sensitivity but low specificity for the diagnosis of acute aortic dissection (AAD). Previous reports indicated that negative D-dimer patients have shorter dissection length. However, whether patients with negative D-dimer results have a good prognosis is unknown. This study aimed to elucidate the clinical characteristics and implications of a negative D-dimer result on AAD diagnosis.METHODS:
The study group comprised 126 patients (71 males, 55 females; mean age, 69⯱â¯11â¯years) with AAD admitted to our hospital between April 2009 and March 2015. Blood samples on presentation were used for D-dimer measurement. Clinical characteristics and outcomes were assessed.RESULTS:
Nine (7.1%) and 117 (92.9%) exhibited negative and positive D-dimer results, respectively. The negative group showed a significantly lower extension score and a higher platelet count than the positive group. Multivariate analysis demonstrated that platelet count (odds ratio, 1.31 (1.09-1.58), pâ¯=â¯0.003) and extension score (odds ratio, 0.56 (0.33-0.96), pâ¯=â¯0.03) were significantly related to a negative result. Notably, 44% of patients in the negative group had type A dissection and 33% underwent an emergency operation due to cardiac tamponade.CONCLUSION:
We found that high platelet count and low extension score were independent factors related to a negative D-dimer result. Even if the length of the dissection is short, an emergency operation is necessary in some patients with a negative D-dimer result. Physicians should recognize that a negative D-dimer result alone cannot exclude patients with fatal AAD conditions.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Aneurisma Aórtico
/
Produtos de Degradação da Fibrina e do Fibrinogênio
/
Dissecção Aórtica
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article