Abstract
OBJECTIVES: Acute aortic dissection (AAD) is a life-threatening condition with difficulty in early differential diagnosis, and ideal biomarkers are still lacking. This study aims to investigate the diagnostic value of serum semaphorin 7A (Sema7A), calponin 1 (CNN1), and plasma D-dimer, alone and in combination, in patients with AAD. METHODS: A retrospective study was conducted. 90 patients with AAD who visited the Second Xiangya Hospital of Central South University from December 2022 to December 2023 were enrolled, along with 53 patients with acute myocardial infarction (AMI) and 18 patients with acute pulmonary embolism (APE). Additionally, 25 patients without chest pain symptoms or cardiogenic diseases admitted during the same period were included as the control group. General clinical data and laboratory indicators were collected. Serum Sema7A and CNN1 levels were detected using enzyme-linked immunosorbent assay or chemiluminescence immunoassay. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for AAD. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic value of D-dimer, Sema7A, and CNN1. RESULTS: Serum Sema7A and CNN1 levels in the AAD group were significantly higher than those in the control, AMI, and APE groups (all P<0.05). D-dimer levels in the AAD group were significantly higher than those in the AMI and control groups (all P<0.05), but showed no significant difference compared with the APE group (P>0.05). Binary logistic regression analysis showed that elevated levels of Sema7A (OR=2.138, P<0.001), D-dimer (OR=1.211, P=0.002), and CNN1 (OR=1.042, P=0.016) were independent risk factors for AAD. ROC curve analysis demonstrated that the areas under the curve (AUC) for Sema7A, CNN1, and D-dimer for distinguishing AAD from non-AAD patients were 0.870, 0.726, and 0.836, respectively (all P<0.001). The combined AUC of the three markers was 0.910 (P<0.001), which was higher than that of each single marker (P<0.05), with sensitivity and specificity of 80.0% and 91.7%, respectively. The combined AUC for distinguishing type A and type B AAD patients was 0.631 (P<0.05). CONCLUSIONS: The combined application of Sema7A, CNN1, and D-dimer significantly improves the diagnostic performance for AAD and may also serve as an indicative marker for clinical classification, providing new insights for the early differential diagnosis of AAD.