Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection

Purpose Coagulation-fibrinolysis markers are widely used for the diagnosis of Stanford type A acute aortic dissection (SAAAD). However, the role of these markers in estimating prognosis remains unclear. Methods A single-center retrospective study was conducted to identify the relationship between pr...

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Autores principales:	Daisuke Arima MD, Yoshihiro Suematsu MD, PhD, Kanan Kurahashi MD, Satoshi Nishi MD, Akihiro Yoshimoto MD
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/d1530eea284d4e61bb6e19a32e147e12
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spelling	oai:doaj.org-article:d1530eea284d4e61bb6e19a32e147e122021-11-23T23:03:19ZUse of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection2048-004010.1177/20480040211047122https://doaj.org/article/d1530eea284d4e61bb6e19a32e147e122021-11-01T00:00:00Zhttps://doi.org/10.1177/20480040211047122https://doaj.org/toc/2048-0040Purpose Coagulation-fibrinolysis markers are widely used for the diagnosis of Stanford type A acute aortic dissection (SAAAD). However, the role of these markers in estimating prognosis remains unclear. Methods A single-center retrospective study was conducted to identify the relationship between preoperative D-dimer and fibrinogen levels on SAAAD postoperative early prognosis. Results Of 238 SAAAD patients who underwent surgery between January 2012 and December 2018, 201 (84.5%) and 37 (15.5%) patients constituted the survival and non-survival groups, respectively, 30 days after surgery. D-dimer and fibrinogen levels in the survival and non-survival groups were 45.2 ± 74.3 vs. 91.5 ± 103.6 μg/mL ( p = 0.014) and 224.3 ± 95.6 vs. 179.9 ± 96.7 μg/mL ( p = 0.012), respectively. According to logistic predictor analysis of 30-day mortality, significant factors showed patent type (OR 10.89, 95% CI 1.66–20.31) and malperfusion (OR 4.63, 95% CI 1.74–12.32). Increasing D-dimer (per +10 μg/mL) and decreasing fibrinogen (per −10 μg/mL) were significantly associated with patent type and malperfusion. Receiver operating characteristic analysis was performed to distinguish between survival and non-survival. The cutoff value of D-dimer was 60 μg/mL (sensitivity 61.1%; specificity 82.5%; area under curve [AUC] 0.713 ± 0.083); fibrinogen was 150 mg/dL (sensitivity 44.4%; specificity 84.0%; AUC 0.647 ± 0.092). Kaplan-Meier survival curve analysis showed that patients with D-dimer levels > 60 μg/mL and fibrinogen levels < 150 mg/dL had significantly low survival rates at 30 days after surgery (60.0%, p < 0.001). Conclusion Preoperative coagulation-fibrinolysis markers may be useful for predicting early prognosis in SAAAD.Daisuke Arima MDYoshihiro Suematsu MD, PhDKanan Kurahashi MDSatoshi Nishi MDAkihiro Yoshimoto MDSAGE PublishingarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENJRSM Cardiovascular Disease, Vol 10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Daisuke Arima MD Yoshihiro Suematsu MD, PhD Kanan Kurahashi MD Satoshi Nishi MD Akihiro Yoshimoto MD Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection
description	Purpose Coagulation-fibrinolysis markers are widely used for the diagnosis of Stanford type A acute aortic dissection (SAAAD). However, the role of these markers in estimating prognosis remains unclear. Methods A single-center retrospective study was conducted to identify the relationship between preoperative D-dimer and fibrinogen levels on SAAAD postoperative early prognosis. Results Of 238 SAAAD patients who underwent surgery between January 2012 and December 2018, 201 (84.5%) and 37 (15.5%) patients constituted the survival and non-survival groups, respectively, 30 days after surgery. D-dimer and fibrinogen levels in the survival and non-survival groups were 45.2 ± 74.3 vs. 91.5 ± 103.6 μg/mL ( p = 0.014) and 224.3 ± 95.6 vs. 179.9 ± 96.7 μg/mL ( p = 0.012), respectively. According to logistic predictor analysis of 30-day mortality, significant factors showed patent type (OR 10.89, 95% CI 1.66–20.31) and malperfusion (OR 4.63, 95% CI 1.74–12.32). Increasing D-dimer (per +10 μg/mL) and decreasing fibrinogen (per −10 μg/mL) were significantly associated with patent type and malperfusion. Receiver operating characteristic analysis was performed to distinguish between survival and non-survival. The cutoff value of D-dimer was 60 μg/mL (sensitivity 61.1%; specificity 82.5%; area under curve [AUC] 0.713 ± 0.083); fibrinogen was 150 mg/dL (sensitivity 44.4%; specificity 84.0%; AUC 0.647 ± 0.092). Kaplan-Meier survival curve analysis showed that patients with D-dimer levels > 60 μg/mL and fibrinogen levels < 150 mg/dL had significantly low survival rates at 30 days after surgery (60.0%, p < 0.001). Conclusion Preoperative coagulation-fibrinolysis markers may be useful for predicting early prognosis in SAAAD.
format	article
author	Daisuke Arima MD Yoshihiro Suematsu MD, PhD Kanan Kurahashi MD Satoshi Nishi MD Akihiro Yoshimoto MD
author_facet	Daisuke Arima MD Yoshihiro Suematsu MD, PhD Kanan Kurahashi MD Satoshi Nishi MD Akihiro Yoshimoto MD
author_sort	Daisuke Arima MD
title	Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection
title_short	Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection
title_full	Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection
title_fullStr	Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection
title_full_unstemmed	Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection
title_sort	use of coagulation-fibrinolysis markers for prognostication of stanford type a acute aortic dissection
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/d1530eea284d4e61bb6e19a32e147e12
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_version_	1718416122651344896

Use of coagulation-fibrinolysis markers for prognostication of Stanford type A acute aortic dissection

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