Significance of Biomarker Panel Including Cardiac Troponin I, D-dimer, and B-Type Natriuretic Peptide in Acute Aortic Dissection Pages 58-63

Carlos Jerjes-Sanchez1, Nualik Garcia2, Enrique Diaz de Leon-Gonzalez3, Anabel Garcia-Sosa4 and Carlos Jerjes Sanchez Ramirez5

1Instituto de Cardiología y Medicina Vascular,TEC Salud y Escuela de Medicina y Ciencias de la Salud del Sistema Tecnológico de Monterrey and Director of Unidad de Investigacion Clinica en Medicina SC, Mexico; 2Hospital de Cardiologia No 34, IMSS, Monterrey, NL, Mexico; 3Hospital de Especialidades No. 25, IMSS, Monterrey, NL, Mexico; 4Emergency Care Department, Hospital de Cardiologia No 34, IMSS, Monterrey, NL, Mexico; 5Escuela de Medicina y Ciencias de la Salud del Sistema Tecnológico de Monterrey, Nuevo León, Mexico

DOI: http://dx.doi.org/10.12970/2311-052X.2013.01.02.4

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Abstract: We assessed whether elevated serum cardiac troponin I (cTnI), D-dimer and B-type natriuretic peptide were associated with short-term mortality in patients with acute aortic dissection (AAD).From 2010 to 2011, 6455 consecutive patients with acute chest pain were admitted to our emergency department, 15 (0.23%) of whom had AAD diagnosed and biomarker data collected. AAD was confirmed on transthoracic esophageal echocardiogram and computed tomography. Patients with abnormal cTnI concentrations had a higher rate of mortality. In univariate analysis, elevated cTnl was an independent predictor of in-hospital mortality (relative risk 27.46, 95% confidence interval 1.20–629.31). No relationship between mortality and D-dimer, B-type natriuretic peptide or the DeBakeyclassifications was identified. In conclusion, elevated serum cTnI identifiesAAD patients at high risk of in-hospital mortality. These findings suggest that cTnl may be a promising tool for rapid risk stratification of patients with AAD.

Keywords: Acute aortic dissection, B-type natriuretic peptide, D-dimer, cardiac troponin I, risk stratification. Read more