{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T21:03:03Z","timestamp":1763154183765,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T00:00:00Z","timestamp":1700265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Type A acute aortic syndrome (urgent AAS, UAAS) has a low incidence and high mortality rate; however, it is often missed or diagnosed late. Our aim was to create a new tool for distinguishing UAAS by using multiple modalities to select patients for CT aortography. This study included 75 patients with UAAS, 77 with acute coronary syndrome (ACS), and 81 with heart failure (HF) who received urgent treatment after propensity matching. Specific symptoms, past medical history, mediastinal width, region of interest (ROI) ratio in the lung base\/apex, D-dimers, and troponin I were investigated to differentiate UAAS from ACS and HF. The most significant variables were selected to create a new scoring system. The UAAS score exhibited a performance AUC of 0.982. A simple UAAS score &gt;1, excluding ROI ratios in lung base\/apex, showed an AUC of 0.977, a sensitivity of 96%, and specificity of 92.41%. The results were validated using an external data set of 292 patients (simple UAAS score &gt; 1: AUC of 0.966, sensitivity 93.33%, and specificity 95.36%). The simple UAAS score may be a valuable tool for suspecting UAAS and may reduce the likelihood of misdiagnosis or performing unnecessary CT aortography.<\/jats:p>","DOI":"10.3390\/diagnostics13223472","type":"journal-article","created":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T07:33:18Z","timestamp":1700292798000},"page":"3472","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A Novel Tool for Distinguishing Type A Acute Aortic Syndrome from Heart Failure and Acute Coronary Syndrome"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7626-8909","authenticated-orcid":false,"given":"Min Joon","family":"Seo","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Dong-A University College of Medicine, Busan 49201, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5815-6994","authenticated-orcid":false,"given":"Jae Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Dong-A University College of Medicine, Busan 49201, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang-Weon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Inje University Busan Paik Hospital, Busan 47392, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1007\/s11886-014-0536-x","article-title":"Diagnosis and management of acute aortic syndromes: Dissection, intramural hematoma, and penetrating aortic ulcer","volume":"16","author":"Bonaca","year":"2014","journal-title":"Curr. 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