Accuracy of a diagnostic strategy combining aortic dissection detection risk score and D-dimer levels in patients with suspected acute aortic syndrome

• Published in: European heart journal. Acute cardiovascular care 2017-08, Vol.6 (5), p.371-378
• Main Authors: Gorla, Riccardo, Erbel, Raimund, Kahlert, Philipp, Tsagakis, Konstantinos, Jakob, Heinz, Mahabadi, Amir-Abbas, Schlosser, Thomas, Eggebrecht, Holger, Bossone, Eduardo, Jánosi, Rolf Alexander
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Algorithms; Aneurysm, Dissecting - blood; Aneurysm, Dissecting - diagnosis; Aneurysm, Dissecting - epidemiology; Aortic Aneurysm - blood; Aortic Aneurysm - diagnosis; Aortic Aneurysm - epidemiology; Biomarkers - blood; Female; Fibrin Fibrinogen Degradation Products - metabolism; Follow-Up Studies; Germany - epidemiology; Hospital Mortality - trends; Humans; Male; Middle Aged; Practice Guidelines as Topic; Prevalence; Prognosis; Protein Multimerization; Reproducibility of Results; Retrospective Studies; Risk Factors; Survival Rate - trends; Syndrome
• ISSN: 2048-8726; 2048-8734
• DOI: 10.1177/2048872615594497

Aims: The European Society of Cardiology recently proposed a novel diagnostic algorithm combining the aortic dissection detection (ADD) risk score with D-dimer level assessment for detecting acute aortic syndromes (AASs) in patients presenting with chest pain. The diagnostic accuracy of this strategy is yet to be validated. Methods: We retrospectively identified 376 patients with chest pain and available D-dimer on admission to the emergency department of our institution between January 2011 and May 2014. The ADD risk score was calculated using retrospective blinded chart review. A score ⩽1 was defined as ‘low probability’, whereas a score >1 as ‘high probability’. AASs were diagnosed in 85 (22.6%) patients. Results: Patients with AAS more frequently had a ‘high probability’ score than AAS-negative patients (63.5% vs 1.0%; P