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Aortic Dissection Detection Risk Score and D-Dimer for Acute Aortic Syndromes in the Chinese Population: Exploration of Optimal Thresholds and Integrated Diagnostic Value

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Abstract

This study aimed to assess the diagnostic performance of the aortic dissection detection risk score (ADD-RS) plus D-dimer for acute aortic syndrome (AAS) in Chinese patients. Two hundred and sixty-two and 200 patients with suspected AAS symptoms were enrolled as exploration cohort and validation cohort, respectively. In exploration cohort, ADD-RS plus D-dimer (AUC = 0.929, 95%CI: 0.887–0.971) presented a better diagnostic value for AAS than ADD-RS or D-dimer alone. Meanwhile, ADD-RS > 1 and D-dimer > 2000 ng/mL were the optimal thresholds. Then, a diagnostic model integrating ADD-RS > 1 plus D-dimer > 2000 ng/mL was established, presenting sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 92.5%, 70.3%, 34.9%, and 98.2%, respectively. In validation cohort, the established diagnostic model exhibited a sensitivity, specificity, PPV, and NPV of 93.1%, 70.2%, 34.6%, and 98.4%, respectively, for diagnosing AAS. Summarily, ADD-RS > 1 and D-dimer > 2000 ng/mL are optimal thresholds for diagnosing AAS in the Chinese population. However, confirmative MSCT results are necessary.

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  • 06 December 2023

    A note has been added to the article since its original publication to clarify the status of the corresponding authors.

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Funding

This study was supported by Project funded by China Postdoctoral Science Foundation (2021M702780), Postdoctor Science Foundation of Heilongjiang Province (2022) and National Natural Science Foundation of China (81900369).

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Author notes

  1. Li Deng and Qingping Xia contributed equally to this work.

Authors and Affiliations

  1. Department of Extracorporeal Life Support, The People’s Hospital of Gaozhou, Gaozhou, 525200, China

    Li Deng & Fei Lin

  2. Department of Cardiovascular Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China

    Li Deng

  3. Department of Science and Education, The People’s Hospital of Gaozhou, Gaozhou, 525200, China

    Qingping Xia

  4. Department of Cardiothoracic Surgery, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, 518000, China

    Liwei Diao

  5. Department of Cardiovascular Surgery, The People’s Hospital of Gaozhou, Gaozhou, 525200, China

    Yong Cao

  6. Shuren International College of Shenyang Medical College, 146 Huanghe North Street, Shenyang, 110000, Liaoning, China

    Hongguang Han

  7. Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, No. 23 Youzheng St, Harbin, 150001, China

    Mowei Song

Authors
  1. Li Deng
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  2. Qingping Xia
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  3. Liwei Diao
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  4. Fei Lin
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  5. Yong Cao
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  6. Hongguang Han
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Corresponding authors

Correspondence to Hongguang Han or Mowei Song.

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Ethics Approval

Study approval was obtained from the Institutional Review Board (GYLLPJ-2020039), and patients or their family members provided written informed consent

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The authors declare no competing interests.

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Editor-in-Chief Enrique Lara-Pezzi oversaw the review of this article.

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Dr. Mowei Song is the main corresponding author of the article.

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Deng, L., Xia, Q., Diao, L. et al. Aortic Dissection Detection Risk Score and D-Dimer for Acute Aortic Syndromes in the Chinese Population: Exploration of Optimal Thresholds and Integrated Diagnostic Value. J. of Cardiovasc. Trans. Res. 16, 886–895 (2023). https://doi.org/10.1007/s12265-023-10354-0

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  • DOI: https://doi.org/10.1007/s12265-023-10354-0

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