The Prognostic Value of D-dimer Testing and Its Role in the Prompt Diagnosis of Atypical Acute Aortic Dissection

Abstract

Background: Acute aortic syndrome is a life-threatening condition, and its timely diagnosis poses a significant clinical challenge. Observations during the COVID-19 pandemic suggest that the routine measurement of D-dimer levels contributed to a substantial improvement in the timely diagnosis of acute aortic dissection, particularly in atypical presentations. Objectives: To evaluate the role of D-dimer as a diagnostic biomarker for facilitating the timely diagnosis of type A acute aortic dissection. Methods: We retrospectively analyzed two cohorts of patients: one from the pre-COVID pandemic period (2018) and the other from the COVID pandemic period (2020). We compared referral times and the relationship between these groups' D-dimer levels and diagnostic efficiency. Results: The findings demonstrate that D-dimer testing significantly expedited surgical intervention in patients with suspected type A acute aortic dissection, which remains the definitive treatment for this condition. Conclusions: The COVID-19 pandemic highlighted the utility of D-dimer measurement in patients with acute symptoms suggestive of aortic dissection. This readily accessible laboratory test can be implemented across various levels of healthcare facilities and plays a pivotal role in the timely diagnosis and prognosis of critical conditions.