主动脉夹层与其他动脉综合症的生物学标志.pdfVIP

Journal of the American College of Cardiology Vol. 56, No. 19, 2010 © 2010 by the American College of Cardiology Foundation ISSN 0735-1097/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2010.01.076 Biomarkers in Acute Aortic Dissection and Other Aortic Syndromes Aaron M. Ranasinghe, MD, Robert S. Bonser, MD Birmingham, United Kingdom Acute aortic syndromes have an incidence of 30 per million per annum and a high mortality without definitive treatment. Survival may relate to the speed of diagnosis. Although pain is the most common symptom, there is a large fraction of patients in whom the diagnosis may be mistaken or overlooked. Currently, a high index of clinical suspicion is the chief prompt that diverts a patient into a definitive algorithm of imaging investigations. Although there is no point-of-care biochemical test that can be reliably used to positively identify dissection, biomarkers are available that could accelerate the diagnostic pathway and thereby expedite treatment. (J Am Coll Cardiol 2010;56:1535–41) © 2010 by the American College of Cardiology Foundation Acute aortic dissection (AAD) is the most common thoracic (4,10). Other acute aortic syndromes (AAS), intramural aortic emergency and may be rapidly fatal without early hematoma, and deep penetrating ulcers may have similar diagnosis and appropriate management (1,2). Symptoms, presentations and prognosis but may cause less medial signs, electrocardiograms (ECGs), and chest