Division of Cardiothoracic and Vascular Surgery, Sino-Swiss Heart-Lung Transplantation Institute, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Key Laboratory of Organ Transplantation, Ministry of Education; NHC Key Laboratory of Organ Transplantation; Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, Hubei, China.
Dis Markers. 2022 Jul 20;2022:9716424. doi: 10.1155/2022/9716424. eCollection 2022.
The misdiagnosis of aortic dissection (AD) can lead to a catastrophic prognosis. There is currently a lack of stable serological indicators with excellent efficacy for the differential diagnosis of AD and coronary artery disease (CAD). A recent study has shown an association between AD and iron metabolism. Thus, we investigated whether iron metabolism could discriminate AD from CAD.
This retrospective and multicenter cross-sectional study investigated the efficacy of biomarkers of iron metabolism for the differential diagnosis of AD. We collected biomarkers of iron metabolism, liver function, kidney function, and other biochemistry test, and further, logistic regression analysis was applied.
Between Oct. 8, 2020, and Mar. 1, 2021, we recruited 521 patients diagnosed with AD, CAD, and other cardiovascular diseases (OCDs) with the main symptoms of chest and back pain and assigned them to discovery set ( = 330) or validation set ( = 191). We found that six serum biomarkers, including serum iron, low-density lipoprotein, uric acid, transferrin, high-density lipoprotein, and estimated glomerular filtration rate, can serve as a novel comprehensive indicator (named FLUTHE) for the differential diagnosis of AD and CAD with a sensitivity of 0.954 and specificity of 0.905 to differentially diagnose AD and CAD more than 72 h past symptom onset.
Our findings provide insight into the role of iron metabolism in diagnosing and distinguishing AD, which might in the future be a key component in AD diagnosis. Furthermore, we establish a novel model named "FLUTHE" with higher efficiency, safety, and economy, especially for patients with chest pain for more than 72 h.
主动脉夹层（AD）的误诊可能导致灾难性的预后。目前，缺乏用于 AD 和冠心病（CAD）鉴别诊断的具有优异疗效的稳定血清学指标。最近的一项研究表明 AD 与铁代谢之间存在关联。因此，我们研究了铁代谢是否可以区分 AD 和 CAD。
本回顾性多中心横断面研究探讨了铁代谢生物标志物在 AD 鉴别诊断中的功效。我们收集了铁代谢、肝功能、肾功能和其他生化检验的生物标志物，并进一步应用了逻辑回归分析。
2020 年 10 月 8 日至 2021 年 3 月 1 日期间，我们招募了 521 例以胸痛和背痛为主诉的 AD、CAD 和其他心血管疾病（OCD）患者，将其分为发现集（=330）或验证集（=191）。我们发现，包括血清铁、低密度脂蛋白、尿酸、转铁蛋白、高密度脂蛋白和估计肾小球滤过率在内的 6 种血清生物标志物可作为一种新的综合指标（命名为 FLUTHE），用于 AD 和 CAD 的鉴别诊断，其对症状发作超过 72 h 的 AD 和 CAD 的鉴别诊断的灵敏度为 0.954，特异性为 0.905。
我们的研究结果提供了铁代谢在 AD 诊断和鉴别中的作用的见解，这可能是未来 AD 诊断的关键组成部分。此外，我们建立了一种名为“FLUTHE”的新型模型，其具有更高的效率、安全性和经济性，尤其适用于胸痛超过 72 h 的患者。
