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The role of D-dimers in the diagnosis of acute aortic dissection

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Abstract

Acute aortic dissection (AAD) is a life threatening cardiovascular medical emergency with a poor prognosis. To explore the utility of D-dimers (DD) in the diagnosis of AAD, we performed a prospective study and conducted a meta-analysis of previous studies. 368 suspected patients were enrolled, including AAD n = 89, PE n = 12, AMI n = 167, normal controls n = 100. All patients had a DD test immediately after admission. We then performed a comprehensive computer search to identify studies investigating using DD as a screening tool for AAD. Finally, we pooled these data to estimate sensitivity, specificity, positive and negative likelihood ratios (LRs) by using DerSimonian–Laird random-effects models. The DD concentrations in the AAD group were significantly higher than those in the AMI and normal control groups. However, the DD level of 500 ng/ml had a poor sensitivity of 51.7 % and specificity of 89.2 % in the diagnosis of AAD. Subgroup analyses found that DD only showed a well discriminative ability of distinguishing AAD patients from normal controls (specificity and positive LR was 97 % and 17.2, respectively). The pooled sensitivity, specificity, positive and negative LR in our meta-analysis was 89, 68 %, 2.71, 0.07, respectively. In conclusion, our results suggest that plasma DD levels cannot add to the certainty of AAD diagnosis and it is not a good biomarker for AAD. In the future, prospective research on patients from many parts of the world is warranted to validate our findings. In addition, different controls, methods of plasma DD assays and other factors should be considered.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, Second People’s Hospital of Wuxi Affiliated to Nanjing Medical University, 68 Zhongshan Road, Wuxi, 214002, People’s Republic of China

    Ning Shao

  2. Department of Respiration, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 210000, People’s Republic of China

    Shan Xia

  3. Department of Emergency, Jiangsu Province Geriatric Hospital, 65 Jiangsu Road, Nanjing, 210024, People’s Republic of China

    Jia Wang

  4. Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, People’s Republic of China

    Xin Zhou, Zebo Huang & Wei Zhu

  5. Department of Emergency, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China

    Yan Chen

Authors
  1. Ning Shao
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  2. Shan Xia
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  3. Jia Wang
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  4. Xin Zhou
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  5. Zebo Huang
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  6. Wei Zhu
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  7. Yan Chen
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Corresponding authors

Correspondence to Wei Zhu or Yan Chen.

Additional information

Ning Shao, Shan Xia, and Jia Wang contributed equally to the present work and each is considered as first author.

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Shao, N., Xia, S., Wang, J. et al. The role of D-dimers in the diagnosis of acute aortic dissection. Mol Biol Rep 41, 6397–6403 (2014). https://doi.org/10.1007/s11033-014-3520-z

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  • DOI: https://doi.org/10.1007/s11033-014-3520-z

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