Predictive Value of D-dimer on Mortality in Patients with Acute Aortic Dissection

Abstract ObjectiveTo clarify the relation between D-dimer and in-hospital mortality of acute aortic dissection, a meta-analysis was performed by summarizing all relevant studies.MethodsAll related studies were retrieved and identified in PubMed and Embase databases. Precise data was extracted from standard articles, such as sample size, odds ratio, and 95% confidence interval. Then pooled odds ratio (OR) accompanying 95% confidence interval (CI) were calculated using random model. Study heterogeneity examined by Q text and I2 statistic. Sensitivity analysis was performed to assess the stability of the results. Publication bias was assessed by Egger’s test. ResultsTen studies (1954 patients) that met the inclusion criteria were included in this review. The results suggested a link between D-dimer and in-hospital mortality of acute aortic dissection (OR=1.17 95%CI=1.08-1.27). With higher of cutoff value of D-dimer, the closer for the mortality of AAD, with ORs (95% CIs) ranging from 1.13(1.09–1.16) to 4.12 (1.56–10.93). The relationship was also found in six Type A AAD studies without heterogeneity (OR=1.13 95%CI=1.08-1.18). According to sensitivity analysis, the link was stable after exclusion of one study at a time. Publication bias was find among studies (P=0.02). ConclusionsThe result of this meta-analysis indicated that D-dimer maybe a predictor in-hospital mortality of acute aortic dissection patients. What’s more, the higher of cutoff value of D-dimer, the stronger for the predictive ability.