Biomarkers for Risk Stratification in Patients With Type A Acute Aortic Dissection

Type A acute aortic dissection (AAD) is a fatal disease and thus, accurate and objective risk stratification is essential. In this study, we evaluated the prognostic value of readily available and assessable biomarkers in patients with type A AAD. This was a retrospective, multicenter, observational...

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Bibliographic Details
Published in:The American journal of cardiology 2024-02, Vol.212, p.103-108
Main Authors: Yamamoto, Kayo, Saito, Yuichi, Hashimoto, Osamu, Nakayama, Takashi, Okino, Shinichi, Sakai, Yoshiaki, Nakamura, Yoshitake, Fukuzawa, Shigeru, Himi, Toshiharu, Kobayashi, Yoshio
Format: Article
Language:English
Subjects:
Aorta
Aortic dissection
Bilirubin
Biomarkers
Brain natriuretic peptide
Cardiac arrest
Clinical medicine
Computed tomography
Coronary vessels
Creatinine
Decision making
Dissection
Fatalities
Heart
Heart surgery
Hemoglobin
Hospitalization
Hospitals
Kinases
L-Lactate dehydrogenase
Lactate dehydrogenase
Mortality
Observational studies
Patients
Tomography
Troponin
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Summary:Type A acute aortic dissection (AAD) is a fatal disease and thus, accurate and objective risk stratification is essential. In this study, we evaluated the prognostic value of readily available and assessable biomarkers in patients with type A AAD. This was a retrospective, multicenter, observational study. A total of 703 patients with type A AAD diagnosed using contrast-enhanced computed tomography were included. Therapeutic strategies were left to the physician's discretion in a real-world clinical setting. The prognostic value for in-hospital mortality was examined in 15 circulating biomarkers on admission, which are routinely available in clinical practice. Of the 703 patients, 126 (17.9%) died during the hospitalization. Of the 15 biomarkers, the multivariable analysis identified positive cardiac troponin, a low total bilirubin (T-Bil) level, and increased levels of brain natriuretic peptide (BNP) and lactate dehydrogenase (LDH) as significant predictors of in-hospital death. The receiver operating characteristics curve analysis showed that these 4 biomarkers had an independent additive prognostic value. With the cut-off values of T-Bil, BNP, and LDH, in combination with positive troponin, the increase in the number of positive biomarkers was progressively associated with higher in-hospital mortality from 1.3% to 9.8%, 20.5%, 36.4%, and 75.0% (p
ISSN:0002-9149
1879-1913
1879-1913
DOI:10.1016/j.amjcard.2023.11.053