D-Dimer as a Test for Aortic Dissection: Relevant or Not?

Previous studies have shown that d-dimer levels tend to be high in the presence of aortic dissection and low in its absence. But is d-dimer testing sufficiently sensitive to contribute to clinical decision making? To find out, investigators conducted a meta-analysis to assess the negative predictive value of a normal d-dimer result among patients evaluated for aortic dissection. They analyzed the results according to pretest risk determined by an American Heart Association risk score. The score designates a patient as low risk if there are no high risk findings, which range from Marfan syndrome to new aortic insufficiency murmur, but, importantly, include chest, back, or abdominal pain of abrupt onset, severe intensity, and ripping or teari…