Zhao Hong-Lei, Tang Zhi-Wei, Diao Yi-Fei, Xu Xiu-Fan, Qian Si-Chong, Li Hai-Yang, Shao Yong-Feng, Zhao Sheng, Liu Hong
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People's Republic of China.
Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300#, Nanjing, 210029, People's Republic of China.
J Cardiovasc Transl Res. 2023 Dec;16(6):1383-1391. doi: 10.1007/s12265-023-10436-z. Epub 2023 Sep 15.
Association of distinct inflammatory profiles with short-term mortality is little known in type A aortic dissection (TAAD). Latent class analysis was used to identify distinct inflammatory profiles based on leukocyte, neutrophils, monocyte, lymphocytes, platelet, fibrinogen, D-dimer, neutrophils-lymphocyte ratio, platelet-lymphocyte ratio, and lymphocyte-monocyte ratio. We identified 193 patients with median age of 56 (IQR 47-63) years and 146 males. Patients were divided as hyper-inflammatory profiles (84 [43.5%]) and hypo-inflammatory profiles (109 [56.5%]). Although baseline characteristics were not different, hyper-inflammatory patients had higher 6-month mortality (20 [23.8%] vs. 11 [10.1%]; P = 0.014) and 30-day mortality (18 [21.4%] vs. 9 [8.3%], P = 0.009) than hypo-inflammatory patients. After adjustment for potential confounders, hyper-inflammatory profiles remain associated with higher risk of 6-month mortality than hypo-inflammatory profiles (adjusted OR 2.427 [95%CI 1.154, 5.105], P = 0.019). Assessment of preoperative inflammatory profiles adds clarity regarding the extent of inflammatory response to TAAD aetiopathologies, highlighting individual anti-inflammatory pharmacotherapy for TAAD. ClinicalTrials.gov Identifier: NCT04398992.
在A型主动脉夹层（TAAD）中，不同炎症特征与短期死亡率之间的关联鲜为人知。采用潜在类别分析，基于白细胞、中性粒细胞、单核细胞、淋巴细胞、血小板、纤维蛋白原、D-二聚体、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值以及淋巴细胞与单核细胞比值来识别不同的炎症特征。我们纳入了193例患者，中位年龄为56岁（四分位间距47 - 63岁），其中男性146例。患者被分为高炎症特征组（84例[43.5%]）和低炎症特征组（109例[56.5%]）。尽管基线特征无差异，但高炎症特征组患者的6个月死亡率（20例[23.8%]对11例[10.1%]；P = 0.014）和30天死亡率（18例[21.4%]对9例[8.3%]，P = 0.009）均高于低炎症特征组患者。在对潜在混杂因素进行校正后，高炎症特征组与6个月死亡率较高的风险仍相关，高于低炎症特征组（校正后的比值比2.427[95%置信区间1.154, 5.105]，P = 0.019）。术前炎症特征的评估有助于更清楚地了解TAAD病因病理的炎症反应程度，突出了针对TAAD的个体化抗炎药物治疗。ClinicalTrials.gov标识符：NCT04398992。
