Jiang Wenjian, Xue Yuan, Li Haibin, Zhang Hongjia, Zhao Yuanfei
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.
Front Cardiovasc Med. 2020 Nov 3;7:587996. doi: 10.3389/fcvm.2020.587996. eCollection 2020.
Surgical repair of acute type A aortic dissection (ATAAD) has high risk and mortality, and there are few biomarkers of postoperative in-hospital mortality until now. This study investigated the association between WW domain-containing transcription regulator protein 1 (TAZ) and the postoperative in-hospital mortality of ATAAD patients. This is a retrospective cohort study. Data and blood samples were collected from 95 consecutive patients with ATAAD who underwent surgeries in our hospital from July 1, 2016, to December 31, 2016. The data collection included all the risk factors introduced by the modified EuroSCORE (European System for Cardiac Operative Risk Evaluation). The predictors of postoperative in-hospital death were confirmed by univariate regression analysis. Multivariable logistic regressions were used to analyze the association of the preoperative plasma level of TAZ and the postoperative in-hospital mortality of ATAAD patients. In addition, we used the generalized additive model to identify non-linear relationships. Three models were used in the multivariable logistic regression analysis of the relationship between the preoperative plasma level of TAZ and postoperative in-hospital death. In the crude model, the preoperative plasma level of TAZ showed a positive correlation with postoperative in-hospital death [odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.01-1.74, = 0.04]. In adjusted model I and adjusted model II, similar results were found (OR = 1.35, 95% CI: 1.01-1.80, = 0.04 and OR = 1.35, 95% CI: 1.01-1.81, = 0.04). The risk of postoperative in-hospital death in the preoperative plasma level of the TAZ≥12.70 ng/mL group was 10.08 times (OR = 10.08, 95% CI: 1.63-62.37; = 0.01) that of the preoperative plasma level of the TAZ <12.70 ng/mL group. The high preoperative plasma level of TAZ suggested poor surgical prognosis for ATAAD patients. The patients with a preoperative plasma level of TAZ ≥ 12.7 ng/ml had much higher postoperative in-hospital mortality.
急性A型主动脉夹层（ATAAD）的外科修复手术风险高、死亡率高，迄今为止，术后院内死亡的生物标志物很少。本研究调查了含WW结构域转录调节蛋白1（TAZ）与ATAAD患者术后院内死亡率之间的关联。这是一项回顾性队列研究。收集了2016年7月1日至2016年12月31日在我院接受手术的95例连续ATAAD患者的数据和血样。数据收集包括改良欧洲心脏手术风险评估系统（EuroSCORE）引入的所有风险因素。通过单因素回归分析确定术后院内死亡的预测因素。采用多变量逻辑回归分析术前TAZ血浆水平与ATAAD患者术后院内死亡率的关联。此外，我们使用广义相加模型来识别非线性关系。在术前TAZ血浆水平与术后院内死亡关系的多变量逻辑回归分析中使用了三个模型。在粗模型中，术前TAZ血浆水平与术后院内死亡呈正相关[比值比（OR）=1.33，95%置信区间（CI）：1.01-1.74，P = 0.04]。在调整模型I和调整模型II中，发现了类似的结果（OR = 1.35，95%CI：1.01-1.80，P = 0.04和OR = 1.35，95%CI：1.01-1.81，P = 0.04）。术前TAZ血浆水平≥12.70 ng/mL组术后院内死亡风险是术前TAZ血浆水平<12.70 ng/mL组的10.08倍（OR = 10.08，95%CI：1.63-62.37；P = 0.01）。术前TAZ血浆水平高提示ATAAD患者手术预后差。术前TAZ血浆水平≥12.7 ng/ml的患者术后院内死亡率高得多。
