The Relationship Between D-dimer Level and In-hospital Mortality in Patients with Acute Aortic Dissection at National Cardiovascular Center Harapan Kita

Author : M. Riyandi, L. Pribadi, M. Fauziah, S. Adiarto
Upload Date : 19-04-2018

Background: Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency with a mortality rate of 1–2% per hour, early after symptom onset. Plasma D-Dimer, a degradation product of cross-linked fibrin, has been validates a diagnostic tool to help in patients with AAD. Elevated D-dimer level also positively correlated with the anatomical extension of the dissection to the different segments of the aorta and whether it may have prognostic value will be discussed in this study.

Method: There are 117 patients was presented to the emergency unit and diagnosed as acute aortic dissection from Januari 1st 2014 until December 31st 2016 in National Cardiovascular Center Harapan Kita, D-dimer level was examined in these patients and we retrospectively analyze inhospital mortality according to d-dimer level among AAD patients when they are presented to the emergency unit.

Results: Total sample of the population is 117 (95 men and 22 women) and the mean age of our population is 55±12.9 with hypertension as dominant risk factor (79,5%).  Inhospital mortality from January 1st, 2014 to December 31st, 2016 was 30 cases (25,6%) and predominantly found in aortic dissection Stanford A de bakey type 1 (34,6% from 52 cases) compared with aortic dissection Stanford A de bakey type 2 (25 % from 12 cases) and aortic dissection Stanford B de bakey type 3 (17, 6% from 51 cases). Median D-dimer value of 3310 ng/ml (interquartile range 1635-6018 ng/mL).  A positive relationship was observed between D-dimer and in-hospital mortality rate among aortic dissection  patients (p=0,039).

Conclusion: D-dimers that elevated in patients with aortic dissection provide prognostic information. This finding should give a better consideration to clinician about risk of in-hospital mortality among aortic dissection patients.

KEYWORDS : Aortic dissection; D-Dimer; Prognostic; Mortality

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