Re-elevation of d-dimer as a predictor of re-dissection and venous thromboembolism after Stanford type B acute aortic dissection

• Published in: Heart and Vessels Vol. 25; no. 6; pp. 509 - 514
• Main Authors: Jo, Yusuke, Anzai, Toshihisa, Ueno, Koji, Kaneko, Hidehiro, Kohno, Takashi, Sugano, Yasuo, Maekawa, Yuichiro, Yoshikawa, Tsutomu, Shimizu, Hideyuki, Yozu, Ryohei, Ogawa, Satoshi
• Format: Journal Article
• Language: English
• Published: Japan Springer Science and Business Media LLC 01.11.2010; Springer Japan; Springer Nature B.V
• Subjects: Acute Disease; Aged; Aneurysm, Dissecting - blood; Aneurysm, Dissecting - complications; Aneurysm, Dissecting - diagnostic imaging; Aneurysm, Dissecting - therapy; Aortic Aneurysm; Aortic Aneurysm - blood; Aortic Aneurysm - complications; Aortic Aneurysm - diagnostic imaging; Aortic Aneurysm - therapy; Aortic Dissection; Biomarkers; Biomarkers - blood; Biomedical Engineering and Bioengineering; Blood clots; Cardiac Surgery; Cardiology; Coronary vessels; Female; Fibrin Fibrinogen Degradation Products; Fibrin Fibrinogen Degradation Products - metabolism; Heart surgery; Humans; Japan; Male; Medical tests; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Admission; Predictive Value of Tests; Proteins; Recurrence; Thromboembolism; Thromboembolism - blood; Thromboembolism - etiology; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Up-Regulation; Vascular Surgery; Veins & arteries; Biomarkers; Aorta; Complications; Dissection; Thrombosis
• ISSN: 0910-8327; 1615-2573; 1615-2573
• DOI: 10.1007/s00380-010-0028-x

d -dimer measurement is a useful complementary initial diagnostic marker in patients with acute aortic dissection (AAD). However, it has not been clarified whether serial measurements of d -dimer are useful during in-hospital management of Stanford type B AAD. We studied 30 patients who were admitted with diagnosis of Stanford type B AAD and treated conservatively. d -dimer was serially measured on admission and then every 5 days during hospitalization. Patients were divided into two groups according to the presence or absence of re-elevation of d -dimer during hospitalization, in which d -dimer transition were biphasic and latter peak >10.0 μg/ml. Re-elevation of d -dimer was observed in 17 patients. There were no differences in atherosclerotic risk factors, blood pressure on admission, d -dimer level on admission, extent of AAD, and false lumen patency. Patients with re-elevation of d -dimer showed higher incidence of re-dissection and/or venous thromboembolism (VTE). Peak d -dimer level in patients with re-dissection and/or VTE was significantly higher than that without these complications ( p  = 0.005). In conclusion, serial measurements of d -dimer are useful for early detection of re-dissection or VTE in patients with Stanford type B AAD, which may contribute to the prevention of disastrous consequences such as pulmonary embolism and extension of AAD.