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Abstract Objective To investigate the value of plasma d- dimer, troponin I and their ratio in etiological diagnosis of acute chest pain. Methods The data of 786 patients (534 male, 252 female, aged from 28 to 93 years) admission for acute chest pain and diagnosed as either acute myocardial infarction (AMI), acute pulmonary embolism (APE) or acute aorta dissection (AAD) were analyzed retrospectively. AMI was divided into ST segment elevation and non- ST segment elevation myocardial infarciton (STEMI, NSTEMI). Serum d- dimer, troponin I and their ratio were analyzed. The receiver operating characteristic curve (ROC curve) was performed to determine the value of d- dimer, troponin I, the ratio of d- dimer to troponin I (Rd) and troponin I to d- dimer (Rc) in the differential diagnosis of STEMI, NSTEMI, APE and AAD. Results D- dimer was significantly higher in AAD(11.13μg/ml) and APE groups(3.92μg/ml)than STEMI(0.38μg/ml) and NSTEMI groups(0.34μg/ml)(al P<0.05). There was significant difference between ADD and APE groups(P<0.05) and no significant difference between STEMI and NSTEMI groups. Troponin I was significantly higher in STEMI group(5.000ng/ml) than in NSTEMI group (3.035 ng/ml)(P<0.05). Both of them were significantly higher than 0.030 ng/ml in APE and AAD groups (al P<0.05). From STEMI to NSTEMI to APE to AAD, Rc was decreasing and Rd was increasing. There was significant difference between any two groups (al P<0.05). The ROC curve showed that Rc was superior to troponin I and Rd superior to d- dimer in the differential diagnosis of these diseases. Conclusion The ratios of D- dimmer to troponin I and troponin I to D- dimmer are benefit to improve the sensitivity and specificity of each parameter in the diagnosis of acute chest pain.
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