Details

Autor(en) / Beteiligte

• Sodeck, Gottfried
• Domanovits, Hans
• Schillinger, Martin
• Ehrlich, Marek P.
• Endler, Georg
• Herkner, Harald
• Laggner, Anton

Titel

D-dimer in ruling out acute aortic dissection: a systematic review and prospective cohort study

Ist Teil von

• European heart journal, 2007-12, Vol.28 (24), p.3067-3075

Ort / Verlag

Oxford: Oxford University Press

Erscheinungsjahr

2007

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Aims Blood D-dimer testing has been proposed as diagnostic marker with high sensitivity for exclusion of acute aortic dissection (AAD). We performed a systematic review and validated the findings in a prospective patient cohort. Methods and results We searched MEDLINE, EMBASE, CINAHL, and BIOSIS from inception until January 2007 using a combination of search terms for aortic dissection and D-dimer. Study type, type of assay used, predefined cut-off level, result of D-dimer testing, sensitivity, and specificity were abstracted. In 16 identified studies (437 patients), the reported cut-off values ranged from 0.1 to 0.9 µg/mL. D-dimer testing provided high sensitivity (0.97 95% CI 0.94–0.98) and negative likelihood ratio (0.06 95% CI 0.02–0.13). In our cohort of 65 patients (36 male, 55%; median age 59 years, IQR 49–67) with proven AAD, D-dimer levels scattered from 0.24 to 137.88 µg/mL (median 3.47; IQR 1.55–14.49). Mean NPV for the different cut-off levels ranged from 92 % for a cut-off level of 0.9 µg/mL to 100% for a cut-off level of 0.1 µg/mL in our study population. Conclusion Current evidence supports a routine measurement of D-dimer in excluding AAD. A D-dimer <0.1 µg/mL will exclude AAD in all cases.