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Inflammatory profiles define phenotypes with clinical relevance in acute type A aortic dissection

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Abstract

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.

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Data Availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Abbreviations

TAAD:

Type A aortic dissection

LCA:

Latent class analysis

ICU:

Intensive care unit

NLR:

Neutrophils-lymphocyte ratio

PLR:

Platelet-lymphocyte ratio

LMR:

Lymphocyte-monocyte ratio

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Funding

This work was supported by Jiangsu Province Capability Improvement Project through Science, Technology and Education (ZDXK202230).

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, People’s Republic of China

    Hong-lei Zhao, Si-chong Qian & Hai-yang Li

  2. Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300#, Nanjing, 210029, People’s Republic of China

    Zhi-wei Tang, Yi-fei Diao, Xiu-fan Xu, Yong-feng Shao, Sheng Zhao & Hong Liu

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  1. Hong-lei Zhao
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on the behalf of the Additive Anti-inflammatory Action for Aortopathy, Arteriopathy (5A) Investigators

Contributions

HL developed the study concept and design, drafted the protocol and analysis plan, and drafted the manuscript. HL and HlZ, paly important role in data review and rectification, and interpretation of revised results. All authors contributed to the interpretation of the findings as well as critical revision of the manuscript for important intellectual content, and approved the final version of the report. HL was responsible for administration and supervision of this study as well as technical or material support. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hong Liu.

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Consent for Publication

This study was approved by Institutional Review Board of the First Affiliated Hospital of Nanjing Medical University (2021-SR-381).

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The authors declare no competing interests.

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Associate Editor Marat Fudim oversaw the review of this article

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Zhao, Hl., Tang, Zw., Diao, Yf. et al. Inflammatory profiles define phenotypes with clinical relevance in acute type A aortic dissection. J. of Cardiovasc. Trans. Res. 16, 1383–1391 (2023). https://doi.org/10.1007/s12265-023-10436-z

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  • DOI: https://doi.org/10.1007/s12265-023-10436-z

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