engleski

C-reactive protein, not cardiac troponin T, improves risk prediction in hypertensives with type A aortic dissection

Background: The aim of the study was to evaluate prognostic role of infl ammatory biomarkers, cardiac troponin T (cTnT) and D-dimer in type A acute aortic dissection (AAD) and to examine whether they might help in risk stratifi cation beyond values of International Registry of Acute Aortic Dissection (IRAD) score. Methods: Baseline biomarkers were determined in 54 consecutive predominantly hypertensive patients with type A AAD and evaluated for in-hospital mortality. Results: After multivariable adjustment, the independent predictors of outcome were age (OR = 1.09 ; 95% CI 1.02 – 1.18), treatment strategy (OR = 0.11 ; 95% CI 0.02 – 0.06) and C-reactive protein (CRP) either as binary (OR = 7.06 ; 95% CI 1.34 – 37.36) or continuous variable (OR = 1.10 ; 95% CI 1.01 – 1.21). cTnT did not independently influence mortality. Receiveroperating characteristic (ROC) curve analysis showed significant link between CRP and outcome (area under the ROC curve, AUC = 0.79 ; p < 0.01). Values of CRP > 9.8 mg/l had 83% sensitivity and 80% specificity for predicting in-hospital mortality. Addition of CRP to IRAD score improved prediction of short-term outcome, AUC increased from 0.74 to 0.89 ( p = 0.004). Conclusion: Admission CRP has independent prognostic value in type A AAD and the addition of CRP to IRAD score improved discriminative capacity of in-hospital mortality irrespective of symptom duration and treatment strategy.

aortic dissection ; C-reactive protein ; D-dimer ; troponin T ; mean platelet volume ; mortality

nije evidentirano