Biomarkers Investigation for In-Hospital Death in Patients With Stanford Type A Acute Aortic Dissection

Int Heart J. 2016 Sep 28;57(5):622-6. doi: 10.1536/ihj.15-484. Epub 2016 Sep 5.

Abstract

This retrospective study aimed to investigate the predictive value of biomarkers for in-hospital mortality of patients with Stanford type A acute aortic dissection (AAD).AAD is a life-threatening disease with an incidence of about 2.6-3.6 cases per 100,000/year.A total of 67 consecutive Stanford type A AAD patients admitted to hospital were divided into a deceased group and survival group. The baseline information of the patients between two groups was systematically compared, followed by examination of the electrocardiograms (ECG). Based on the follow-up during hospitalization, we investigated the simultaneous assessment of indexes like fragmented QRS complex (fQRS), admission systolic blood pressure (SBP), aortic diameter, surgical management, troponin I (TnI), white blood cell (WBC) count, N-terminal pro-brain natriuretic peptide (NT-proBNP), and D-dimer.The levels of TnI and NT-proBNP, WBC counts, and rate of fQRS (+) in patients of the deceased group were significantly higher than those in the survival group. The male sex (hazard ratio, 10.88; P = 0.001), admission SBP (hazard ratio, 0.98; P = 0.012), NT-proBNP (hazard ratio, 1.00; P = 0.001), and WBC count (hazard ratio, 1.10; P = 0.033) were independently related with in-hospital death. As a single marker, WBC count had the highest sensitivity at 84.6% (specificity 65.9%).Admission SBP, NT-proBNP, and WBC count were potential independent risk factors of in-hospital death in Stanford type A AAD patients. WBC count may be a more accurate predictor of type A AAD than either alone.

MeSH terms

  • Adult
  • Aortic Aneurysm, Thoracic / blood*
  • Aortic Aneurysm, Thoracic / diagnosis
  • Aortic Aneurysm, Thoracic / mortality*
  • Aortic Dissection / blood*
  • Aortic Dissection / diagnosis
  • Aortic Dissection / mortality*
  • Biomarkers / blood
  • Blood Pressure / physiology
  • China
  • Electrocardiography
  • Female
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Hospital Mortality*
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood
  • Peptide Fragments / blood
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Troponin I / blood

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • Peptide Fragments
  • Troponin I
  • fibrin fragment D
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain