C-reactive Protein in Prognosis of Chronic Aortic Dissection

The prognosis of chronic aortic dissection lies in the existence of thrombus blockage and in the degree of blood pressure control of the false lumen, among other prognostic factors reported. The incidence of aortic dissection increases with age. Despite advances in diagnostic techniques, the mortality in the acute phase in Japan is substantially high. In the chronic phase, computed tomography (CT) and magnetic resonance imaging (MRI) are used for follow-up. In the acute phase, type A aortic dissection requires immediate operative intervention. In acute type B aortic dissection, treatment consists mainly of anti-hypertensive therapy and bed rest. 5 In addition, cases needing surgery in the subacute phase and those with lesion progression in the chronic phase are also included in the acute type B aortic dissection group. Therefore, if conservative treatment is chosen for aortic dissection cases, the diagnosis in the acute phase as well as the prognosis in the chronic stage must be Abstract: Objective: To examine a correlation between the clinical prognosis and inflammatory reaction in aortic dissection. Design: Twenty-six patients who underwent medical treatment for chronic aortic dissection were divided into the high risk group (H) of 7 patients with a progressive focus on the chronic phase, and the low risk group (L) of 19 patients without progressive focus. The patients were monitored using their hematological findings and inflammatory scintigraphy (In-WBC). Results: No change was observed in the C-reactive protein (CRP) values during the acute phase in both groups. However, during the subacute phase, the CRP values in the high risk group were significantly higher than those in the low risk group (p<0.05). In-WBC results revealed that a persistent positive accumulation remained during the chronic phase in all high risk patients. Conclusion: Monitoring the changes in CRP and In-WBC in all phases can provide prognostic information about treatment planning. (J Jpn Coll Angiol, 2005, 45: 241–246)