Prognostic prediction of Stanford type A acute aortic dissection using D-dimer

Abstract

Background—The Stanford type A acute aortic dissection (AAD), whereby the dissection extends to the ascending aorta, results in high mortality. The plasma D-dimer has been used in the diagnosis of acute aortic dissection. However, its prognostic value in patients with the Stanford type A AAD has not been clarified. We investigated the prognostic value of the D-dimer in patients with Stanford type A AAD. Methods and Results—103 patients with Stanford type A AAD (mean age, 69.8 ± 13.0 years; male, 41; female, 62) were included. The level of the D-dimer was high in all the patients (34.3 ± 56.3 μg/mL). The D-dimer level in the patients of the nonsurvival group was higher than that of the survival group (36.8 μg/mL vs 8.5 μg/mL, p < 0.001). Receiver operating characteristic curve analysis showed that the cut-off level of the D-dimer was 9.71 μg/mL in nonsurviving patients with Stanford type A AAD. Kaplan–Meier curve analysis showed that a D-dimer level of more than 9.71 μg/mL indicates an increase in acute-period mortality (p < 0.001). Conclusion—It is suggested that a high plasma D-dimer level on admission is useful for the prognostic prediction for patients with Stanford type A AAD.