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. 2023 Dec;16(6):1383-1391.
doi: 10.1007/s12265-023-10436-z. Epub 2023 Sep 15.

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

Hong-Lei Zhao  1 , Zhi-Wei Tang  2 , Yi-Fei Diao  2 , Xiu-Fan Xu  2 , Si-Chong Qian  1 , Hai-Yang Li  1 , Yong-Feng Shao  2 , Sheng Zhao  2 , Hong Liu  3 ; on the behalf of the Additive Anti-inflammatory Action for Aortopathy, Arteriopathy (5A) Investigators
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Inflammatory profiles define phenotypes with clinical relevance in acute type A aortic dissection

Hong-Lei Zhao et al. J Cardiovasc Transl Res. 2023 Dec.

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.

Keywords: Inflammatory response; Latent class analysis; Mortality; Type A aortic dissection.

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