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The present study aimed to investigate the predictive value of various biomarkers for in-hospital mortality of patients with Stanford type A acute aortic dissection (AAD).
This retrospective study included 67 consecutive patients admitted to our hospital for Stanford type A AAD. Patients were divided into two groups: the deceased group (n = 26), consisting of those who died during hospitalization, and the survived group (n = 41). Baseline data including sex, blood pressure, aortic diameter (calculated by computed tomography measurement), surgical management, troponin I (TnI) (associated with myocardial injury), white blood cell (WBC) count (a marker of inflammation), N-terminal pro-brain natriuretic peptide (NT-proBNP) (associated with left ventricular dysfunction), fragmented QRS complex (fQRS) (an index of adverse cardiovascular events), and fibrin D-dimer (an index of thrombogenesis) were collected. The data on in-hospital mortality were analyzed.
The deceased group had significantly higher admission systolic blood pressure (SBP), aortic diameter, TnI, WBC counts, and NT-proBNP levels and higher rate of fQRS(+) than the survived group. Admission SBP, aortic diameter, WBC count, TnI, and D-dimer were found to be independently related with in-hospital death by multivariate logistic regression analysis. Elevated D-dimer, fQRS(+), NT-proBNP, TnI, and WBC count had a sensitivity of 96.2% and specificity of 85.4% for the prognosis of in-hospital death of Stanford type A AAD patients.
Admission SBP, aortic diameter, TnI, WBC count, and D-dimer were important risk factors and independently associated with in-hospital death of Stanford type A AAD patients. Biomarkers including TnI, WBC count, fQRS, fibrin D-dimer, and NT-proBNP have a strong predictive value for in-hospital mortality in patients with Stanford type A AAD, with a worse outcome for those with highly elevated biomarkers.