AUTHOR=Pan Xiaogao , Zhou Yang , Yang Guifang , He Zhibiao , Zhang Hongliang , Peng Zhenyu , Peng Wen , Guo Tuo , Zeng Mengping , Ding Ning , Chai Xiangping 

TITLE=Lysophosphatidic Acid May Be a Novel Biomarker for Early Acute Aortic Dissection

JOURNAL=Frontiers in Surgery

VOLUME=8

YEAR=2022

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.789992

DOI=10.3389/fsurg.2021.789992

ISSN=2296-875X

ABSTRACT=<p><bold>Background:</bold> Misdiagnosis and delayed diagnosis of acute aortic dissection (AAD) significantly increase mortality. Lysophosphatidic acid (LPA) is a biomarker related to coagulation cascade and cardiovascular-injury. The extent of LPA elevation in AAD and whether it can discriminate sudden-onset of acute chest pain are currently unclear.</p><p><bold>Methods:</bold> We measured the plasma concentration of LPA in a cohort of 174 patients with suspected AAD chest pain and 30 healthy participants. Measures to discriminate AAD from other acute-onset thoracalgia were compared and calculated.</p><p><bold>Results:</bold> LPA was significantly higher in AAD than in the AMI, PE, and the healthy (344.69 ± 59.99 vs. 286.79 ± 43.01 vs. 286.61 ± 43.32 vs. 96.08 ± 11.93, <italic>P</italic> &lt; 0.01) within 48 h of symptom onset. LPA level peaked at 12 h after symptom onset, then gradually decreased from 12 to 48 h in AAD. LPA had an AUC of 0.85 (0.80–0.90), diagnosis threshold of 298.98 mg/dl, a sensitivity of 0.81, specificity of 0.77, and the negative predictive value of 0.85. The ROC curve of LPA is better than D-dimer (<italic>P</italic> = 0.041, Delong test). The decision curve showed that LPA had excellent standardized net benefits.</p><p><bold>Conclusion:</bold> LPA showed superior overall diagnostic performance to D-dimer in early AAD diagnosis may be a potential biomarker, but additional studies are needed to determine the rapid and cost-effective diagnostic tests in the emergency department.</p>