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Re-elevation of d-dimer as a predictor of re-dissection and venous thromboembolism after Stanford type B acute aortic dissection

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Abstract

d-dimer measurement is a useful complementary initial diagnostic marker in patients with acute aortic dissection (AAD). However, it has not been clarified whether serial measurements of d-dimer are useful during in-hospital management of Stanford type B AAD. We studied 30 patients who were admitted with diagnosis of Stanford type B AAD and treated conservatively. d-dimer was serially measured on admission and then every 5 days during hospitalization. Patients were divided into two groups according to the presence or absence of re-elevation of d-dimer during hospitalization, in which d-dimer transition were biphasic and latter peak >10.0 μg/ml. Re-elevation of d-dimer was observed in 17 patients. There were no differences in atherosclerotic risk factors, blood pressure on admission, d-dimer level on admission, extent of AAD, and false lumen patency. Patients with re-elevation of d-dimer showed higher incidence of re-dissection and/or venous thromboembolism (VTE). Peak d-dimer level in patients with re-dissection and/or VTE was significantly higher than that without these complications (p = 0.005). In conclusion, serial measurements of d-dimer are useful for early detection of re-dissection or VTE in patients with Stanford type B AAD, which may contribute to the prevention of disastrous consequences such as pulmonary embolism and extension of AAD.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Yusuke Jo, Toshihisa Anzai, Koji Ueno, Hidehiro Kaneko, Takashi Kohno, Yasuo Sugano, Yuichiro Maekawa, Tsutomu Yoshikawa & Satoshi Ogawa

  2. Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan

    Hideyuki Shimizu & Ryohei Yozu

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  1. Yusuke Jo
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  2. Toshihisa Anzai
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  3. Koji Ueno
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  4. Hidehiro Kaneko
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  5. Takashi Kohno
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  6. Yasuo Sugano
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  7. Yuichiro Maekawa
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  8. Tsutomu Yoshikawa
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  9. Hideyuki Shimizu
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  11. Satoshi Ogawa
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Correspondence to Toshihisa Anzai.

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Jo, Y., Anzai, T., Ueno, K. et al. Re-elevation of d-dimer as a predictor of re-dissection and venous thromboembolism after Stanford type B acute aortic dissection. Heart Vessels 25, 509–514 (2010). https://doi.org/10.1007/s00380-010-0028-x

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  • DOI: https://doi.org/10.1007/s00380-010-0028-x

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