Abstract

Objective: The aim of this study wasto evaluate whether there is difference of serum D-dimer between patients with aortic intramural hematoma and patients with classic acute aortic dissection.

Methods: According to results of computerized tomographic angiography, all the patients, who had established diagnosis of acute aortic syndrome in the past four years in an affiliated hospital, were retrospectively classified into two groups: classic acute aortic dissection (AAD) group and aortic intramural hematoma (AIH) group. The serum D-dimer concentration at admission and other clinical baseline characteristics between the two groups were compared. Furthermore, the occurrence of main clinical complication was compared between the two groups. Fifty-one subjects were included. Thirty-eight patients (74.5%) were in AAD group and thirteen (25.5%) in AIH group, respectively.

Results: D-dimer levels were significantly higher in AAD group (3.50 ± 1.72 mg/mL) than in AIH group (1.54 ± 1.50 mg/mL, p < 0.05). All patients with AAD had D-dimer levels above the threshold of 0.50 ng/mL (sensitivity 100%). However, two patients in AIH group presented D-dimer levels below the threshold. The sensitivity of the D-dimer test in detecting AIH was 84.6% (11/13). But there was no significant difference in sensitivity between the two groups (p >0.05). The main clinical complication rate was 39.5% (15/38) in AAD group and 30.8% (4/13) in AIH group (p > 0.05).

Conclusion: D-dimer levels are lower in patients with AIH than those in patients with AAD. Although it shows no difference of sensitivity between AAD and AIH, D-dimer can be negative in AAD patients. Moreover, patients with AIH have a similar clinical evolution during hospitalization compared to patients with AAD.