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

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.