title: Admission Values of D-dimer and C-reactive Protein (CRP) Predict the Long-term Outcomes in Acute Aortic Dissection.
abstract: Objective Admission D-dimer and C-reactive protein (CRP) values have been reported to predict the short-term outcomes in acute aortic dissection (AAD). However, the association between D-dimer values and the long-term outcomes has not been investigated. Methods The primary endpoints included events determined to be all-cause death, recurrence of aortic dissection, aortic rupture, and surgical intervention for the aortic aneurysm following the first hospital discharge. We performed a receiver operating characteristic analysis and determined the optimal cut-off levels of admission D-dimer, admission CRP and peak CRP values in terms of the sensitivity and specificity for predicting the presence of events. Using the optimal cut-off values, we performed a multiple Cox analysis and investigated the hazard ratio of admission D-dimer, admission CRP and peak CRP. Patients We retrospectively identified 173 AAD patients hospitalized between January 2005 and December 2013. Results A multiple Cox regression analysis revealed that the hazard ratios were 3.4 for admission D-dimer [95% Confidence Interval (CI) 1.5 to 7.3, p=0.004] and 2.7 for admission CRP (95% CI 1.2 to 5.5, p=0.014). Conclusion Admission D-dimer and CRP values may predict the long-term outcomes in AAD. Moreover, admission D-dimer values may be a valuable marker to predict not only the short-term outcomes, but also the long-term outcomes in AAD.
authors.affiliation: Department of Emergency Rescue, Tokyo Metropolitan Tama Medical Center, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mori
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Tamune
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000097:blood* / Q000503:physiopathology; D001014:Aortic Aneurysm / Q000097:blood* / Q000503:physiopathology; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D002097:C-Reactive Protein