Diagnosis value of five biomarkers for acute aortic dissection

Ma Fangfang; Xiu Qiuping; Xie Huabin

doi:10.3969/j.issn.1674-7151.2023.04.001

Abstract：Objective To investigate the diagnostic value of five biomarkers for patients with acute aortic dissection(AAD).Methods The 106 confirmed AAD patients admitted in Affiliated Cardiovascular Disease Hospital of Xiamen University from June 2022 to February 2023 were selected as AAD group,including 70 cases of A-type AAD patients and 36 cases of B-type AAD patients,and 92 patients with acute myocardial infarction(AMI)were selected as AMI group.Additionally,100 healthy individuals who underwent physical examinations during the same period were selected as control group.The basic data of three groups of patients were collected,and the levels of heparin binding protein(HBP),interleukin-6(IL-6),white blood cell count(WBC),neutrophil count(NEU),lymphocyte count(LYM),platelet count(PLT)and D-dimer were detected,the levels of platelet to lymphocyte ratio(PLR)and neutrophil to lymphocyte ratio(NLR)were calculated,and the differences of the above indicators between two groups were compared.The receiver operator characteristic(ROC)curve was drawn and the area under ROC curve(AUC)was calculated to evaluate the diagnostic value of five biomarkers for AAD.Results ① The levels of WBC,NEU,NLR,PLR,HBP,IL-6 and D-dimer in AAD and AMI groups were significantly higher than those in control group[WBC(×109/L):14.20±4.20,12.97±4.98 vs.6.08±1.50,NEU(×109/L):12.35±3.91,10.45±4.61 vs.3.60±1.33,NLR:14.68±7.74,8.13±6.71 vs.1.94±0.86,PLR:198.63±115.52,175.28±129.27 vs.127.60±36.41,HBP(μg/L):50.11±44.90,25.85±20.71 vs.6.65±3.80,IL-6(ng/L):71.92±37.28,37.14±10.56 vs.2.60±1.85,D-dimer(mg/L):18.71±22.95,2.54±5.39 vs.0.28±0.10,all P<0.05].The levels of WBC,NEU,NLR,HBP,IL-6 and D-dimer in AAD group were significantly higher than those in AMI group,while the levels of PLT and LYM were significantly lower than those in AMI group(all P<0.05),while the difference in PLR was not statistically significant(P>0.05).The levels of PLT and LYM in AAD group were significantly lower than those in control group[PLT(×109/L):168.82±64.80 vs.238.05±49.10,LYM(×109/L):1.07±0.66 vs.1.96±0.51,both P<0.05].There were no statistically significant differences in PLT and LYM levels between AMI group and control group.② The D-dimer levels in A-type AAD patients were significantly lower than those in B-type AAD patients(mg/L:19.67±16.83 vs.12.03±9.87,P<0.05).The AUC for identifying AAD and AMI using D-dimer,NLR,IL-6,HBP and PLR were 0.885,0.773,0.768,0.624 and 0.591,respectively.The 95%confidence intervals(95%CI)were 0.821-0.934,0.707-0.840,0.680-0.857,0.512-0.735 and 0.512-0.671,respectively(all P<0.05).Conclusion Five indicators are helpful in assisting the diagnosis of AAD.D-dimer,NLR and IL-6 have high differential diagnostic value for AAD,and D-dimer has auxiliary diagnostic value for AAD classification.