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

Figures & data

Table I. Baseline characteristics of patients with type A acute aortic dissection.

Variables	All (n = 54)	Survived (n = 30)	Died (n = 24)	p-value
Demographics
Age, years	69 ± 14	62 ± 12	77 ± 13	< 0.001
Male gender, n (%)	34 (63)	20 (67)	14 (58)	0.729
History
Hypertension, n (%)	50 (93)	26 (87)	24 (100)	0.182
Diabetes mellitus, n (%)	5 (9)	2 (7)	3 (13)	0.754
Dyslipidemia, n (%)	18 (33)	10 (33)	8 (33)	0.772
Smoking, n (%)	25 (46)	16 (53)	9 (39)	0.376
Clinical characteristics
Time to admission, h	2.3 (1–6)	2.8 (1–5)	2 (1–6.5)	0.732
Admission SBP, mmHg	115 (90–134)	113 (90–130)	120 (91–148)	0.588
Admission DBP, mmHg	70 (60–80)	70 (60–80)	75 (60–95)	0.196
Heart rate, per min	65 (59–79)	64 (60–75)	72 (55–80)	0.993
Aortic diameter, mm	48.7 ± 6.7	48.6 ± 7.5	48.8 ± 5.6	0.923
LV ejection fraction, %	56 ± 6.5	57 ± 6.6	55 ± 6.4	0.425
Surgical treatment, n (%)	32 (59)	25 (83)	7 (29)	< 0.001
IRAD score	3.3 ± 1.2	2.8 ± 1.2	3.8 ± 1.1	0.004
Laboratory parameters
CRP, mg/l	9.15 (4.1–17)	5.0 (2.5–8.5)	15.7 (10.8–21.4)	< 0.001
D-dimer, μg/ml	4.3 (1.6–5.1)	3.7 (0.9–5.4)	4.5 (3.8–5.2)	0.241
cTnT, ≥ 0.01 ng/ml	18 (33)	7 (23)	11 (46)	0.092
Fibrinogen, g/l	3.6 ± 1.4	3.4 ± 1.1	3.7 ± 1.7	0.519
WBC, × 10^9/l	12.4 ± 4.8	11.8 ± 4.2	13.2 ± 5.5	0.334
Platelet count, × 10^9/l	194 ± 64	191 ± 62	199 ± 67	0.641
MPV, fl	8.4 ± 1.0	8.3 ± 1.0	8.5 ± 1.0	0.548
Hemoglobin, g/l	137 (124–147)	138 (126–147)	137 (123–147)	0.690
eGFR, mL/min	57 ± 14	59 ± 10	54 ± 18	0.186

SBP, systolic blood pressure; DBP, diastolic blood pressure; LV, left ventricular; IRAD, International Registry of Acute Aortic Dissection; CRP, C-reactive protein; cTnT, cardiac troponin T; WBC, white blood cells; MPV, mean platelet volume; eGFR, estimated glomerular filtration rate. Categorical variables are presented as absolute (relative) frequencies and continuous variables as mean± standard deviation or median (interquartile range). Differences between the groups are determined by t-test or Mann–Whitney test for continuous variables and by chi-square test for categorical variables.

Table II. Predictors of in-hospital mortality in type A acute aortic dissection.

	Univariate model		Multivariate model
Variables	OR (95% CI)	p-value	OR (95% CI)	p-value
Age	1.10 (1.04–1.17)	0.0008	1.09 (1.02–1.18)	0.014
Surgical treatment	0.08 (0.02–0.30)	0.0002	0.11 (0.02–0.60)	0.011
CRP	1.11 (1.03–1.20)	0.0082	1.10 (1.01–1.21)	0.040
CRP (> 9.8 mg/l)	20.00 (4.94–80.89)	0.0001	7.06 (1.34–37.36)	0.021
TnT (≥ 0.01 ng/ml)	2.78 (0.9–8.93)	0.080	–

OR, odds ratio; CI, confidence interval; CRP, C-reactive protein; TnT, cardiac troponin T.

Figure 1. Receiver-operating characteristic curves (ROC) for ability of: (A) C-reactive protein (CRP); (B) International Registry of Acute Aortic Dissection (IRAD) score alone and in combination with CRP to predict in-hospital mortality in type A acute aortic dissection. AUC, area under the ROC curve.