There were no differences when the subgroups of patients with TAA or TAD were compared {Selleck Anti-diabetic Compound Library|Selleck Antidiabetic Compound Library|Selleck Anti-diabetic Compound Library|Selleck Antidiabetic Compound Library|Selleckchem Anti-diabetic Compound Library|Selleckchem Antidiabetic Compound Library|Selleckchem Anti-diabetic Compound Library|Selleckchem Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|Anti-diabetic Compound Library|Antidiabetic Compound Library|buy Anti-diabetic Compound Library|Anti-diabetic Compound Library ic50|Anti-diabetic Compound Library price|Anti-diabetic Compound Library cost|Anti-diabetic Compound Library solubility dmso|Anti-diabetic Compound Library purchase|Anti-diabetic Compound Library manufacturer|Anti-diabetic Compound Library research buy|Anti-diabetic Compound Library order|Anti-diabetic Compound Library mouse|Anti-diabetic Compound Library chemical structure|Anti-diabetic Compound Library mw|Anti-diabetic Compound Library molecular weight|Anti-diabetic Compound Library datasheet|Anti-diabetic Compound Library supplier|Anti-diabetic Compound Library in vitro|Anti-diabetic Compound Library cell line|Anti-diabetic Compound Library concentration|Anti-diabetic Compound Library nmr|Anti-diabetic Compound Library in vivo|Anti-diabetic Compound Library clinical trial|Anti-diabetic Compound Library cell assay|Anti-diabetic Compound Library screening|Anti-diabetic Compound Library high throughput|buy Antidiabetic Compound Library|Antidiabetic Compound Library ic50|Antidiabetic Compound Library price|Antidiabetic Compound Library cost|Antidiabetic Compound Library solubility dmso|Antidiabetic Compound Library purchase|Antidiabetic Compound Library manufacturer|Antidiabetic Compound Library research buy|Antidiabetic Compound Library order|Antidiabetic Compound Library chemical structure|Antidiabetic Compound Library datasheet|Antidiabetic Compound Library supplier|Antidiabetic Compound Library in vitro|Antidiabetic Compound Library cell line|Antidiabetic Compound Library concentration|Antidiabetic Compound Library clinical trial|Antidiabetic Compound Library cell assay|Antidiabetic Compound Library screening|Antidiabetic Compound Library high throughput|Anti-diabetic Compound high throughput screening| to each other (data now shown). Table 6 Multivariate analysis Factor Odd ratio P-value 95% Confidence interval Heart rate 0.97 0.01 0.96 – 0.99 Chest pain 0.24 < 0.001 0.11 – 0.51 Diabetes 0.29 0.004 0.13 – 0.67 Head & neck pain 0.17 0.008 0.05 – 0.63 Dizziness 0.08 0.002 0.02 – 0.39 Myocardial infarction 0.07 0.007 0.01 – 0.48 Discussion An expeditious diagnosis of thoracic aortic pathology in the emergency department remains a great challenge, especially its differentiation from acute coronary syndrome (ACS) [2]. Previous studies have suggested that there are many presenting signs and symptoms for TAD/TAA but

routine blood work and standard imaging have not been Selleckchem BV-6 shown to be reliable nor reproducible [10–12]. Potential genetic markers [13] and biomarkers in rat models [14] have been proposed; however, there is a need for practical and cost effective tools that can be quickly obtained in the emergency department for the routine

screening of patients with acute thoracic complaints. In the present study, we have identified factors that are typically present on admission and routine emergency medical screening. The study group of 136 patients with thoracic aortic dissection (TAD) or aneurysms (TAA) represented a mere 0.36% of the population presenting with acute chest complaints, highlighting the difficulty in diagnosing this rare entity. It would not have been possible to employ contrast-enhanced CT scans on all such patients, especially in an emergency department that sees more than 100,000 patients per year. Pain

characteristics have been shown to be unreliable in a systematic review [2, 15]. The present study shows that the sudden onset in nature was Baricitinib more likely associated with TAA/TAD. This is in concordance with previous report by Klompas et al. [4]. On the other hand, our finding of association with increasing intensity has not been reported in other studies and may explain the evolving nature of thoracic aortic disease. On multivariate analysis, chest pain, head and neck pain, and dizziness were identified to be independently associated with ACS. These all represent easily obtainable factors in routine history taking. As expected, past medical history for the most part was not a useful tool in differentiating TAA/TAD from ACS, as both share similar comorbidities. For example, having a history of hypertension was not a useful tool in differentiating the two disease processes. However, history of diabetes and myocardial infarction was significantly associated with ACS, both in univariate and multivariate analysis, providing another easily obtainable factor in differentiating TAA/TAD from ACS. In fact, diabetes may have a protective association against the development of aortic disease [16].