Abstract:

[Abstract] Objective  To explore the factors that could affect plasma level of D-dimmer test in acute aortic syn? drome. Methods  Blood samples (2 mL) from acute aortic syndrome patients (n=76) obtained immediately after admission to detect D-dimmer using ELISA. Blood routine test and biochemical indicators tests including creatinine were also performed. White blood cell (WBC), serum value of creatinine, aortic contrast-enhanced CT, incidence of Shock and death were all re? corded. The receiver-operating characteristic curve (ROC) was established to assess the potency of D-dimmer to predict hospital mortality. Results  According to ROC analysis, the optimal cut-off value of D-dimmer to predict hospital mortality was >2 988.6 μg/L (FEU), with 86.7% sensitivity and 70.5% specificity. The patients were divided into group A (D-dim? mer < 2 988.6 μg/L FEU, n=45) and group B (D-dimmer ≥ 2 988.6 μg/L FEU，n=31). Onset timing was longer in group A than that in group B（P < 0.01）. Involvement of ascending aorta was less common in group A than in group B（P < 0.05）. Aortic intramural hematoma was less common in group A than in group B（P < 0.05）. Logistic analysis demonstrated that short time of onset, involvement of ascending aorta, non-aortic intramural hematoma were all independent factors of higher D- dimmer (≥2 988.6 μg/L FEU). Conclusion  Patients with long time of onset, without involvement of ascending aorta, with intramural hematoma are liable to have lower values of plasma D-dimmer.

Key words: D dimmer, acute aortic syndrome, Aortic dissection, intramural hematoma