{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T15:15:00Z","timestamp":1789571700093,"version":"build-2803163510"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Acute type A aortic dissection (AAD) and acute type A intramural hematoma (AIMH) are life\u2010threatening conditions with high mortality rates, and prognostic indicators are critical for guiding urgent treatment decisions. We assessed the prognostic significance of admission D\u2010dimer levels in patients with AAD and AIMH.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">The prospective, multicenter, observational study in China recruited participants from 2013 to 2019. Patients with AAD and AIMH were respectively categorized into quartiles based on admission D\u2010dimer levels. Cox regression analysis was used to assess the association between D\u2010dimer levels and mortality. A total of 3132 patients with AAD (mean age: 50.63\u2009years [SD, 12.56]) and 353 patients with AIMH (mean age: 59.63\u2009years [SD, 11.00]) were included. In patients with AAD, overall mortality rates increased across D\u2010dimer quartiles: 13.7% (Q1, \u22640.72 mg\/L), 16.7% (Q2, 0.72\u20131.91 mg\/L), 22.8% (Q3, 1.91\u20134.21 mg\/L), and 28.5% (Q4, 4.21\u201320.00 mg\/L). In patients with AIMH, mortality rates by quartile were 3.4% (Q1, \u22640.51 mg\/L), 5.7% (Q2, 0.51\u20131.25 mg\/L), 4.6% (Q3, 1.25\u20133.44 mg\/L), and 10.2% (Q4, 3.44\u201320.00 mg\/L). After adjusting for confounders, D\u2010dimer was an independent predictor of overall mortality (hazard ratio [HR], 1.42 [95% CI, 1.11\u20131.80]) and in\u2010hospital mortality (HR, 1.47 [95% CI, 1.13\u20131.92]) in patients with AAD. D\u2010dimer levels were not significantly associated with the overall (HR, 2.61 [95% CI, 0.70\u20139.73]) or in\u2010hospital mortality (HR, 1.78 [95% CI, 0.44\u20137.24]) of patients with AIMH by multivariable adjustment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Elevated admission D\u2010dimer levels are independently associated with higher mortality in patients with AAD but are not significantly associated with prognosis in patients with AIMH. Our findings suggest that D\u2010dimer may serve as a useful prognostic marker in patients with AAD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.chictr.org.cn\">www.chictr.org.cn<\/jats:ext-link>\n              . Unique identifier: ChiCTR230006854.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036843","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T11:53:00Z","timestamp":1737028380000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Prognostic Value of D\u2010Dimer in Acute Type A Aortic Dissection and Intramural Hematoma: Observations from the Acute Aortic Syndrome Group of the Registry of Acute Non\u2010Traumatic Chest Pain in China"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1263-5420","authenticated-orcid":false,"given":"Lingyue","family":"Qiu","sequence":"first","affiliation":[{"name":"Guangxi Chest Pain Center, and Department of Cardiology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences Nanning China"},{"name":"Guangxi Chest Pain Center, and Department of Cardiology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6355-433X","authenticated-orcid":false,"given":"Qingwei","family":"Ji","sequence":"additional","affiliation":[{"name":"Guangxi Chest Pain Center, and Department of Cardiology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences Nanning China"},{"name":"Chest Pain Center, and Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, and Beijing Institute of Heart Lung, and Blood Vessel Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huangtai","family":"Miao","sequence":"additional","affiliation":[{"name":"Chest Pain Center, and Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, and Beijing Institute of Heart Lung, and Blood Vessel Diseases Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiying","family":"Long","sequence":"additional","affiliation":[{"name":"Guangxi Chest Pain Center, and Department of Cardiology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, and Institute of Cardiovascular Diseases, Guangxi Academy of Medical Sciences Nanning 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People\u2019s Hospital, Guangdong Academy of Medical Sciences Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianlong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Chest Pain Center, Beijing Chaoyang Integrative Medicine Rescue and First Aid Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohe","family":"Huang","sequence":"additional","affiliation":[{"name":"Chest Pain Center, and Department of Cardiology Affiliated Hospital of Youjiang Medical University for Nationalities Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9385-1159","authenticated-orcid":false,"given":"Yan","family":"Liu","sequence":"additional","affiliation":[{"name":"Chest Pain Center, and Department of Cardiology Affiliated Hospital of Youjiang Medical University for Nationalities Beijing 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