Istituto di Fisiologia Clinica     
Suzuki T., Distante A., Zizza A., Trimarchi S., Villani M., Salerno Uriarte J., De Luca Tupputi Schinosa L., Renzulli A., Sabino F., Nowak R., Birkhahn R., Hollander J., Counselman F., Bossone E., Eagle K. Response to Letter Regarding Article "Diagnosis of Acute Aortic Dissection by D-Dimer: The International Registry of Acute Aortic Dissection Substudy on Biomarkers (IRAD-Bio) Experience". In: Circulation Journal, vol. 1192702-7 (20) pp. 2702 - 2707. American Heart association, 2010.
We thank Dr. Hugli for his/her interest in our manuscript. Dr. Hugli raises issues which were discussed in the manuscript which might benefit by being readdressed in this response. The most notable issue centers on the pre-test probability of acute aortic dissection which is a prerequisite for estimation of diagnostic measures and their clinical usefulness. As yet, we still do not have a firm understanding of this value because sufficient data is not available (e.g. prevalence rates and/or clinical decision rules/tools) to calculate such. Having stated that, however, our study was the first, to our knowledge, to determine the prevalence of acute aortic dissection in patients suspected of having this disease. Our earlier study showed a prevalence of 25%1 and the described study was approximately 40%2.........
Subject Aortic dissection, biomarkers

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