Inflammatory Trajectory and Anti-Inflammatory Pharmacotherapy in Frozen Elephant Trunk-Treated Acute Type I Aortic Dissection.

Autor:	Liu H; Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Diao YF; Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Xu XF; Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Qian SC; Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Shao YF; Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Zhao S; Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China., Sun LZ; Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China., Zhang HJ; Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Jazyk:	angličtina
Zdroj:	Journal of the Society for Cardiovascular Angiography & Interventions [J Soc Cardiovasc Angiogr Interv] 2024 Apr 05; Vol. 3 (7), pp. 101935. Date of Electronic Publication: 2024 Apr 05 (Print Publication: 2024).
DOI:	10.1016/j.jscai.2024.101935
Abstrakt:	Background: Acute DeBakey type I aortic dissection is associated with high morbidity and mortality. Little is known regarding the role of leukocyte trajectory in prognosis. Methods: We included adult acute DeBakey type I aortic dissection patients with emergency frozen elephant trunk and total arch replacement in 2 cardiovascular centers (2020-2022). We used latent class mixed model to group patients according to their leukocyte patterns from hospital admission to the first 5 days after surgery. We investigated the association of leukocyte trajectory and 30-day and latest follow-up mortality (October 31, 2023), exploratorily analyzing the effects of ulinastatin treatment on outcome. Results: Of 255 patients included, 3 distinct leukocyte trajectories were identified: 196 in group I (decreasing trajectory), 34 in group II (stable trajectory), and 25 in group III (rising trajectory). Overall, 30-day mortality was 25 (9.8%), ranging from 8.2% (16/196) in group I, 8.8% (3/34) in group II, to 24.0% (6/25) in group III ( P for trend = .036). Group III was associated with higher mortality both at 30 days (adjusted hazard ratio, 3.260; 95% CI, 1.071-9.919; P = .037) and at the last follow-up (adjusted hazard ratio, 2.840; 95% CI, 1.098-7.345; P = .031) compared with group I. Conclusions: Distinct and clinically relevant groups can be identified by analyzing leukocyte trajectories, and a rising trajectory was associated with higher short-term and midterm mortality. (© 2024 The Author(s).)
Databáze:	MEDLINE
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