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

Blood Press. 2015;24(4):212-6. doi: 10.3109/08037051.2015.1025607. Epub 2015 May 2.

Abstract

Background: The aim of the study was to evaluate prognostic role of inflammatory biomarkers, cardiac troponin T (cTnT) and D-dimer in type A acute aortic dissection (AAD) and to examine whether they might help in risk stratification 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. Receiver- operating 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.

Keywords: Aortic dissection; C-reactive protein; D-dimer; mean platelet volume; mortality; troponin T.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aortic Aneurysm, Thoracic / blood*
  • C-Reactive Protein / metabolism*
  • Female
  • Humans
  • Hypertension / complications*
  • Male
  • Mean Platelet Volume
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors

Substances

  • C-Reactive Protein

Supplementary concepts

  • Aortic Aneurysm, Familial Thoracic 1