title: Lower circulating Sta-Liatest D-Di levels in patients with aortic intramural hematoma compared with classical aortic dissection.
abstract: OBJECTIVE
  To compare the diagnostic value of circulating Sta-Liatest D-Di levels in classic acute aortic dissection (AAD) and in aortic intramural hematoma (AIH), a variant of AAD without a patent false lumen.
  
  
  METHODS
  Single-center retrospective case-control study.
  
  
  METHODS
  University Hospital of Strasbourg, France.
  
  
  METHODS
  Ninety-four consecutive patients with both confirmed AAD and d-dimer measurements at entry were included. d-dimer levels were assayed by the immunoturbidimetric method Sta-Liatest D-Di (Diagnostica Stago, Asnieres sur Seine, France).
  
  
  METHODS
  Patient characteristics and clinical evolution were analyzed.
  
  
  RESULTS
  Eighty-four patients (89%) presented a classic AAD with patent false lumen and ten (11%) presented an AIH. Clinical presentation did not differ between the two groups. The mortality rate was 0% in AIH and 26% in classic AAD. d-dimer levels were significantly lower in patients with AIH (median, 1230 ng/mL; interquartile range, 685-2645 ng/mL) than in patients with AAD with patent false lumen (median value, 9290 ng/mL; interquartile range, 3890-20,000 ng/mL; p = 0.008). All patients with AAD and patent false lumen had d-dimer levels above the threshold of 400 ng/mL (sensitivity 100%). However, one patient with AIH presented d-dimer levels below the threshold. Therefore, the sensitivity of the d-dimer test in detecting AIH was 90%.
  
  
  CONCLUSIONS
  Sta-Liatest D-Di levels are lower in AIH than in AAD with patent false lumen. This test can quite possibly be negative in the case of intramural hematoma. This feature must be considered when interpreting d-dimer levels in patients with acute aortic syndrome.
authors.affiliation: Departments of Cardiac Surgery, University Hospital of Strasbourg, France. patrick.ohlmann@chru-strasbourg.fr
authors.forename: Patrick
authors.initials: P
authors.lastname: Ohlmann
authors.forename: Antoine
authors.initials: A
authors.lastname: Faure
authors.forename: Olivier
authors.initials: O
authors.lastname: Morel
authors.forename: Michel
authors.initials: M
authors.lastname: Kindo
authors.forename: Laurence
authors.initials: L
authors.lastname: Jesel
authors.forename: Bogdan
authors.initials: B
authors.lastname: Radulescu
authors.forename: Philippe
authors.initials: P
authors.lastname: Billaud
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meyer
authors.forename: Hélène
authors.initials: H
authors.lastname: Petit
authors.forename: Annie
authors.initials: A
authors.lastname: Trinh
authors.forename: Eric
authors.initials: E
authors.lastname: Epailly
authors.forename: Gérald
authors.initials: G
authors.lastname: Roul
authors.forename: Michel
authors.initials: M
authors.lastname: Chauvin
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Mazzucotelli
authors.forename: Bernard
authors.initials: B
authors.lastname: Eisenmann
authors.forename: Pierre
authors.initials: P
authors.lastname: Bareiss
mesh_terms: D000208:Acute Disease; D000368:Aged; D001018:Aortic Diseases / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006406:Hematoma / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D