Key result
Abnormal D-dimer levels (OR 14.06), maximum descending aorta diameter (OR 1.11), and ulcer-like projections (OR 5.85) were independent risk factors for aortic-related adverse events in patients with acute type B aortic intramural hematoma.
Why the study?
This study aimed to investigate the short-term predictors of aortic-related adverse events in patients with acute type B aortic intramural hematoma initially treated with optimized medical therapy.
What are the short-term predictors of aortic-related adverse events in patients with acute type B aortic intramural hematoma treated with optimal medical therapy?
Cohort (n=157)
No
What are the short-term predictors of aortic-related adverse events in patients with acute type B aortic intramural hematoma treated with optimal medical therapy?
Abnormal D-dimer, maximum descending aorta diameter > 35.2 mm, and ulcer-like projections are strong predictors of short-term aortic-related adverse events in acute type B IMH, highlighting the need for strict blood pressure control and imaging surveillance.
May refine short-term risk stratification in acute type B IMH; leaves open prospective validation of predictors.
This study aimed to investigate the short-term predictors of aortic-related adverse events in patients with acute type B aortic intramural hematoma (IMH) initially treated with optimized medical therapy.A total of 157 patients with acute type B IMH were included in this study. These patients were divided into worsening group (n = 45) and stable group (n = 112) based on the incidence of aortic-related adverse events. The clinical data and imaging features of the two groups were compared. Multivariate logistic regression analysis of predictors of aortic-related adverse events in type B IMH was performed. Receiver operating characteristic (ROC) curve was applied to determine the optimal cutoff value for maximum descending aorta diameter (MDAD). Kaplan-Meier survival curve was used to analyze the incidence of aortic-related adverse events.Worsening and stable groups were statistically significant in diuretics, abnormal D-dimer level, observation endpoint systolic blood pressure (SBP), MDAD, aortic atherosclerosis, ulcer-like projection (ULP), and thickness of hematoma (P < 0.05). Multivariate logistic regression showed that abnormal D-dimer level (OR = 12.464, P = 0.025), MDAD (OR = 1.113, P = 0.030), and ULP (OR = 5.849, P = 0.022) were powerful independent risk factors for predicting aortic-related adverse events in type B IMH, and observation endpoint SBP within 100-120 mmHg (OR = 0.225, P = 0.014) was a protective factor for predicting aortic-related adverse events in type B IMH. The cutoff value of MDAD was 35.2 mm.Short-term imaging is recommended for type B IMH patients with abnormal D-dimer level, MDAD > 35.2 mm, and ULP. Blood pressure should also be strictly monitored and controlled during the acute phase of IMH.
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Meng et al. (2023) conducted a cohort in Acute type B aortic intramural hematoma (n=157). Abnormal D-dimer level (> 0.5 μg/mL) vs. Normal D-dimer level was evaluated on Aortic-related adverse events (aortic-related death and progression to aortic dissection or penetrating aortic ulcer) (OR 14.060, 95% CI 1.494-132.369, p=0.021). Abnormal D-dimer levels (OR 14.06), maximum descending aorta diameter (OR 1.11), and ulcer-like projections (OR 5.85) were independent risk factors for aortic-related adverse events in patients with acute type B aortic intramural hematoma.
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