The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, Guangdong, China.
Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College (SUMC), Shantou, China.
BMC Cardiovasc Disord. 2020 Dec 9;20(1):515. doi: 10.1186/s12872-020-01806-5.
The association between different ABO blood groups and mortality of aortic dissection (AD) remains controversial. This study aimed to examine whether different ABO blood groups affect the prognosis of AD.
Demographic and clinical data were collected from 877 patients diagnosed with AD from 2015 to 2019 in the First Affiliated Hospital of Shantou University Medical College. The association between in-hospital mortality of AD patients and ABO blood group was analyzed using Cox proportional hazards regression models.
This retrograde cohort study demonstrated that for 877 patients, male gender, non-O blood group, Stanford type B AD (TBAD), higher presenting systolic and diastolic blood pressure, and being a recipient of aortic arch replacement surgery (surgery) or endovascular stent-graft implantation (stent-graft) were associated with decreased in-hospital mortality of AD. In Cox proportional hazards models, non-O blood group was associated with lower risk of early mortality regardless of adjustment (HR = 0.668, 95% confidence interval [CI] 0.473-0.944 before adjustment, HR = 0.662, 95% CI 0.468-0.935 after adjustment for age and sex, and HR = 0.641, 95% CI 0.453-0.906 after adjustment for AD types, SBP and surgery). Further analyses revealed that for patients diagnosed with type A AD (TAAD), non-O blood group renders a significant 34.3% decrease in the risk of in-hospital mortality compared with blood group O. Specifically, this difference in mortality risk was found among TAAD patients who did not undergo surgery (HR = 0.579, 95% CI 0.377-0.889), rather than those who did. There was no significant difference in early mortality for patients with TBAD, whether or not stent-grafts were implanted.
Non-O blood type decreases the risk of in-hospital mortality, especially for TAAD, in AD patients without surgical intervention. More attention must be paid to blood type O TAAD patients without surgical interventions, and early surgical intervention may be an effective means to decrease in-hospital mortality of TAAD.
不同 ABO 血型与主动脉夹层（AD）死亡率之间的关联仍存在争议。本研究旨在探讨不同 ABO 血型是否影响 AD 的预后。
从汕头大学医学院第一附属医院 2015 年至 2019 年收治的 877 例 AD 患者中收集人口统计学和临床数据。使用 Cox 比例风险回归模型分析 AD 患者住院死亡率与 ABO 血型之间的关系。
这项回顾性队列研究表明，对于 877 名患者，男性、非 O 型血、Stanford 型 B 型 AD（TBAD）、较高的收缩压和舒张压以及接受主动脉弓置换术（手术）或血管内支架植入术（支架植入）与 AD 住院死亡率降低相关。在 Cox 比例风险模型中，无论是否进行调整，非 O 型血与早期死亡率风险降低相关（调整前 HR=0.668，95%CI 0.473-0.944，调整年龄和性别后 HR=0.662，95%CI 0.468-0.935，调整 AD 类型、SBP 和手术后 HR=0.641，95%CI 0.453-0.906）。进一步分析表明，对于诊断为 A 型 AD（TAAD）的患者，非 O 型血与住院死亡率风险降低 34.3%相关，而非 O 型血。具体而言，这种死亡率风险差异仅见于未接受手术的 TAAD 患者（HR=0.579，95%CI 0.377-0.889），而非接受手术的患者。对于接受或未接受支架植入的 TBAD 患者，早期死亡率无显著差异。
非 O 型血降低了 AD 患者住院死亡率的风险，尤其是对于未接受手术干预的 TAAD 患者。对于未接受手术干预的 O 型 TAAD 患者，需要更加关注，早期手术干预可能是降低 TAAD 住院死亡率的有效手段。
