World Journal of Cardiovascular Diseases, 2021, 11, 135-144
https://www.scirp.org/journal/wjcd
ISSN Online: 2164-5337
ISSN Print: 2164-5329
DOI: 10.4236/wjcd.2021.112015 Feb. 24, 2021 135 World Journal of Cardiovascular Diseases
Evaluation of D-Dimer as a Diagnostic Tool in
Patients with Acute Aortic Dissection
Samir Rafla
1
, Tarek Bishay
2
1
Cardiology Department, Alexandria University, Alexandria, Egypt
2
National Heart Institute, Cairo, Egypt
Abstract
Acute (Ac.) Aortic Dissection (AD) is a life threatening cardiovascular emer-
gency. The diagnostic methods (e.g., TEE, MRI, Multislice CT) are limited by
availability. A fast, cost effective and technically simple method for diagnosis
of AAD is needed. D-Dimer is a measure of clot formation and lysis. The aim
of this study was to determine whether assessing D-Dimer level can be used
for the diagnosis of AAD. Methods: 45 patients with clinical suspicion of
AAD who presented within the first 24 hours from symptom onset were stu-
died prospectively. 20 patients were proved to have AAD by TEE (group I).
The other 25 patients had other final diagnosis (group II). All the 20 patients
in group I (100%) with confirmed AAD had positive and elevated D-Dimer
levels while only 9 patients in group II (36%) had positive D-Dimer levels (p
< 0.001). Mean D-Dimer level was significantly higher in the 20 patients in
group I than in the 9 patients with positive test in group II (p < 0.01). The
sensitivity of D-Dimer was 100% and the specificity was 64% for the diagnosis
of AAD. Mean D-Dimer level was significantly higher in Stanford type A,
AAD than in Stanford type B, AAD, (p < 0.01). 5 patients (25%) died during
the in–hospital course. Mean D-Dimer level was higher in the patients who
died. Conclusion: D-Dimer levels are positive and elevated in all the patients
with AAD presenting within the first 24 hours from symptom onset.
Keywords
Aortic Dissection, D-Dimer
1. Introduction
AAD is a life threatening cardiovascular emergency with a mortality rate of 1% -
2% per hour [1]. AAD, if not diagnosed early is frequently fatal [2].
How to cite this paper: Rafla, S. and Bi-
shay, T. (2021) Evaluation of D-Dimer as a
Diagnostic Tool in Patients with Acute Aor-
tic Dissection. World Journal of Cardiovas-
cular Diseases, 11, 135-144.
https://doi.org/10.4236/wjcd.2021.112015
Received: December 29, 2020
Accepted: February 21, 2021
Published: February 24, 2021
Copyright © 2021 by author(s) and
Scientific Research Publishing Inc.
This work is licensed under the Creative
Commons Attribution International
License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
Open Access