The Value of D-dimer in the Prognosis and Clinical Classification of Acute Aortic Dissection

  • Hui Chen The Second Hospital of Hebei Medical University
  • Lingling Zhang The Second Hospital of Hebei Medical University
  • Hua Yin The Second Hospital of Hebei Medical University
  • Fei Tong The Second Hospital of Hebei Medical University
  • Shuhua Huo The Second Hospital of Hebei Medical University
DOI: https://doi.org/10.18686/aem.v12i3.409
Keywords: D-Dimer, Acute Aortic Dissection, Prognosis, Clinical Classification

Abstract

Objective: To investigate the prognostic and clinical classification value of D-dimer in acute aortic dissection (AAD), thereby providing a foundation for early clinical attention and proactive intervention. Methods: The clinical data of 74 patients with acute aortic dissection were retrospectively analyzed. Based on the prognosis, they were categorized into two groups: death group and survival group. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with in-hospital mortality in patients with acute aortic dissection (AAD). Similarly, regression analysis was conducted to identify the risk factors for Stanford A acute aortic dissection according to the Stanford classification criteria. Additionally, the prognostic value of D-dimer for both AAD and Stanford A dissection was evaluated using ROC curve analysis. Results: Significant differences were observed in Stanford type A, creatinine, D-dimer, and N-terminal pro-brain natriuretic peptide (NT proBNP) levels between the death group and survival group (P < 0.05). Multivariate regression analysis revealed that D-Dimer (odds ratio [OR] = 1.26, 95% confidence interval [CI]: 1.09-1.46, P = 0.002) and creatinine (OR = 1.02, 95% CI: 1.00-1.03, P = 0.022) independently contributed to the risk of mortality in patients with acute aortic dissection (AAD). The area under the curve (AUC) for D-dimer in predicting in-hospital death was found to be 0.77 with an optimal cut-off point of 6.5 mg/l; yielding a sensitivity of 86% and specificity of 62%. Significant differences were also observed between Stanford A and Stanford B classifications among female patients regarding clinical classification as well as D-Dimer levels (P <0.05). Multivariate analysis demonstrated that D-Dimer (OR=1.18,95 % CI : 1.05-1.32, P=0.005) and female gender (OR=4. 07, 95% CI: 1.24-13.29, P=0.02) were associated with increased risk of Stanford A dissection.The AUC for D-dimer was calculated as 0.69 with a critical point at 10.73mg/L,sensitivity ranged from 55%, and specificity reached 81%. Conclusion: The elevated levels of D-dimer not only serve as a prognostic indicator for mortality in acute aortic dissection but also act as a predisposing factor for Stanford A dissection.

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Published
2023-09-15
Issue
Vol 12 No 3 (2023)
Section
Original Research Article

Copyright (c) 2023 Hui Chen, Lingling Zhang, Hua Yin, Fei Tong, Shuhua Huo

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