Guifang Yang1, Wen Peng2, Yang Zhou2, Huaping He2, Xiaogao Pan2, Yuzhong Cai2, Xiangping Chai3. 1. Department of Emergency Medicine, the Second Xiangya Hospital of Central South University, 139 Renmin road, Changsha, Hunan province 410011, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China. Electronic address: yangguifang@csu.edu.cn. 2. Department of Emergency Medicine, the Second Xiangya Hospital of Central South University, 139 Renmin road, Changsha, Hunan province 410011, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China. 3. Department of Emergency Medicine, the Second Xiangya Hospital of Central South University, 139 Renmin road, Changsha, Hunan province 410011, China; Emergency Medicine and Difficult Diseases Institute, Central South University, Changsha, China. Electronic address: chaixiangping@csu.edu.cn.
Abstract
BACKGROUND: Evidence regarding the characteristics and prognosis in acute type A aortic dissection (AAD) patients with negative D-dimer result is limited. We aimed to investigate the characteristics and prognosis in AAD patients with negative D-dimer result. METHODS AND RESULTS: 370 AAD patients within 24 h of symptom onset were enrolled in a hospital in China from January 2014 to December 2018. Nine (2.43%) and 361 (97.57%) exhibited negative and positive D-dimer results, respectively. The average age of nine negative D-dimer result participants was 47.67 ± 10.95 years old, and about seven (77.78%) of them were male. The negative group showed a significantly lower blood pressure, white blood cell, hemoglobin, activated partial thromboplastin, ejection fraction and symptom with pain than the positive group. Multivariate analysis showed white blood cell (×109/L) (P = 0.008; odds ratio, 0.566) and symptom with pain (P < 0.001; odds ratio, 0.013) were significantly related to a negative result. The result of the fully-adjusted model showed negative D-dimer result was negatively associated with in-hospital mortality compared with positive group in AAD patients after adjusting confounders (OR = 0.34, 95%CI 0.01 to 10.82). CONCLUSIONS: Negative D-dimer result is strongly influenced by white blood cell and symptom with pain. Negative D-dimer result was negatively associated with in-hospital mortality compared with positive group in AAD patients.
BACKGROUND: Evidence regarding the characteristics and prognosis in acute type A aortic dissection (AAD) patients with negative D-dimer result is limited. We aimed to investigate the characteristics and prognosis in AAD patients with negative D-dimer result. METHODS AND RESULTS: 370 AAD patients within 24 h of symptom onset were enrolled in a hospital in China from January 2014 to December 2018. Nine (2.43%) and 361 (97.57%) exhibited negative and positive D-dimer results, respectively. The average age of nine negative D-dimer result participants was 47.67 ± 10.95 years old, and about seven (77.78%) of them were male. The negative group showed a significantly lower blood pressure, white blood cell, hemoglobin, activated partial thromboplastin, ejection fraction and symptom with pain than the positive group. Multivariate analysis showed white blood cell (×109/L) (P = 0.008; odds ratio, 0.566) and symptom with pain (P < 0.001; odds ratio, 0.013) were significantly related to a negative result. The result of the fully-adjusted model showed negative D-dimer result was negatively associated with in-hospital mortality compared with positive group in AAD patients after adjusting confounders (OR = 0.34, 95%CI 0.01 to 10.82). CONCLUSIONS: Negative D-dimer result is strongly influenced by white blood cell and symptom with pain. Negative D-dimer result was negatively associated with in-hospital mortality compared with positive group in AAD patients.