Elevated admission C-reactive protein was significantly associated with complicated or high-risk acute Stanford type B aortic dissection and showed good discriminatory performance, with an AUC of 0.897 and an optimal cutoff of 19.4 mg/L.
Key Findings
Results
Admission CRP levels were significantly higher in complicated/high-risk acute TBAD patients compared to uncomplicated patients.
Complicated/high-risk group median CRP: 74.1 (IQR 27.2, 137.4) mg/L vs. uncomplicated group: 2.9 (IQR 0.6, 9.6) mg/L
Difference was statistically significant at P < 0.001
Study included 95 patients with acute TBAD: 62 classified as complicated/high-risk and 33 as uncomplicated
CRP was measured within 24 hours of admission
Patients were drawn from two centers between January 2010 and January 2025
Results
CRP was significantly associated with complicated/high-risk TBAD in both unadjusted and age- and sex-adjusted logistic regression models.
Unadjusted OR: 1.046 (95% CI, 1.023–1.070; P < 0.001)
Adjusted OR (for age and sex): 1.048 (95% CI, 1.023–1.074; P < 0.001)
The consistency of the OR across adjusted and unadjusted models suggests the association is not substantially confounded by age or sex
Logistic regression analysis was used to evaluate the association
Results
CRP demonstrated good discriminatory performance for identifying complicated/high-risk acute TBAD by ROC curve analysis.
Area under the ROC curve (AUC): 0.897 (95% CI, 0.830–0.964)
Optimal cutoff value: 19.4 mg/L
ROC curve analysis was used to evaluate discriminatory performance
The AUC of 0.897 indicates good discriminatory ability per conventional thresholds
Methods
The study classified patients with acute TBAD as complicated/high-risk or uncomplicated using established guideline criteria.
Classification was based on SVS/STS reporting standards and STS/AATS guidelines
62 of 95 patients (approximately 65%) were classified as complicated/high-risk
33 of 95 patients (approximately 35%) were classified as uncomplicated
This was a retrospective observational study conducted at two centers
Conclusions
The authors concluded that CRP may serve as an adjunctive tool for early risk stratification in acute TBAD due to its accessibility and low cost.
CRP is described as 'a rapid, low-cost, and widely available inflammatory marker'
The authors position CRP as providing adjunctive—not standalone—risk stratification value
The study evaluated CRP specifically as 'a simple, inexpensive, and widely available inflammatory marker for early risk stratification'
The retrospective design and relatively small sample size (n=95) are inherent limitations of the study
What This Means
This research suggests that a common blood test called C-reactive protein (CRP), which measures inflammation in the body, may help doctors quickly identify patients with a serious and potentially life-threatening condition called acute Stanford type B aortic dissection (a tear in the main artery leaving the heart) who are at higher risk or already experiencing complications. In a study of 95 patients at two hospitals over 15 years, those with more severe or complicated cases had dramatically higher CRP levels on admission—about 74 mg/L on average—compared to those with less severe cases, who had levels around 2.9 mg/L. A CRP level above approximately 19.4 mg/L appeared to be a useful threshold for distinguishing higher-risk from lower-risk patients.
The statistical analysis showed that higher CRP was strongly linked to complicated or high-risk disease, even after accounting for patients' age and sex, and the test performed well at distinguishing between the two groups (AUC of 0.897, where 1.0 would be perfect). This research suggests that CRP—already routinely measured in most hospitals and relatively inexpensive—could be added to the information doctors use when first evaluating these patients to help guide how urgently and aggressively they need to be treated.
This matters because aortic dissection is a medical emergency where rapid decision-making is critical, and existing methods for assessing risk can be complex or time-consuming. This research suggests CRP could offer a quick, low-cost, widely available additional data point to support early triage decisions, though the authors emphasize it should be used alongside—not instead of—other clinical assessments. The study's retrospective design and relatively small sample size mean these findings would benefit from confirmation in larger, prospective studies.
Li Z, Zhou Y, Zhang X, Li W, Zhang X, Li Y, et al.. (2026). Elevated admission C-reactive protein identifies complicated or high-risk acute Stanford type B aortic dissection.. Frontiers in immunology. https://doi.org/10.3389/fimmu.2026.1936267