Can D-Dimer Levels Help Rule Out Acute Aortic Dissection?

In a case-control analysis, the negative likelihood ratio associated with levels <500 ng/mL was comparable to that considered sufficient to rule out pulmonary embolism.

Recent reports indicate that d-dimer, a biomarker commonly used in the diagnosis of pulmonary embolism, is also elevated in acute aortic dissection (AD), but its usefulness as a diagnostic tool for this rare condition remains uncertain. In the International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio), supported by the manufacturer of a d-dimer assay, investigators prospectively enrolled 220 patients with suspected AD within 24 hours after symptom onset. Eighty-seven patients were ultimately diagnosed with AD (type A, 64; type B, 23), and 133 were diagnosed with other conditions (controls) including MI; angina; pulmonary embolism; and other, uncertain disorders.

Patients with acute AD had markedly elevated d-dimer l…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)