Key result
High α-HBDH levels on admission predicted in-hospital mortality and postoperative cardiac injury in patients with acute aortic dissection (OR 9.869; 95% CI 2.148-45.349; P=0.003).
Why the study?
Acute aortic dissection carries high mortality and postoperative complication rates, but few indicators predict postoperative cardiac injury complications.
Does α-HBDH level on admission predict in-hospital mortality and postoperative cardiac injury better than LDH in patients with acute aortic dissection?
Cohort (n=369)
Does α-HBDH level on admission predict in-hospital mortality and postoperative cardiac injury better than LDH in patients with acute aortic dissection?
Odds Ratio: 9.869 (95% CI 2.148–45.349)
p-value: p=0.003
α-HBDH is superior to LDH in predicting in-hospital mortality and postoperative cardiac injury in patients with acute aortic dissection, with an optimal cut-off of 204 U/L.
May aid early risk stratification in acute aortic dissection; hypothesis-generating and requires prospective validation versus LDH.
Objective: Acute aortic dissection (AAD) has a high rate of mortality and postoperative complications, but fewer indicators can predict postoperative cardiac injury complications. This study aimed to investigate whether α-HBDH is superior to LDH as a predictor of in-hospital mortality and postoperative cardiac injury in patients with AAD. Methods: In this retrospective study, a total of 369 patients from 2015 to 2021 were enrolled and divided into three groups (T1: low, T2: medium and T3: high) based on the tertiles of α-HBDH levels on admission. The relationship between α-HBDH and AAD was determined by correlation analysis and logistic regression model, with the consolidation using Kaplan-Meier and restricted cubic spline (RCS) analysis for predicting the in-hospital death and cardiac injury complications. Last, the relationship between α-HBDH levels and in-hospital mortality and cardiac injury was further verified through subgroup analysis. Results: In the logistic regression model, α-HBDH in the high-level group was 9.869 times that in the low-level group [OR (95CI): 9.869 (2.148-45.349), P=0.003], while this feature was not observed in LDH [OR (95CI): 1.437 (0.342-6.034), P=0.621]. Kaplan-Meier analysis showed that increased α-HBDH levels within 30 days were associated with poor survival within 30 days in AAD patients (log rank test, P<0.01), especially in acute stanford A dissection. RCS showed that 204 U/L was the optimal cut-off value of α-HBDH for in-hospital mortality and postoperative cardiac injury, which facilitated clinical stratification of patients with AAD. Subgroup analysis confirmed a stable correlation between α-HBDH level and hospital mortality and cardiac injury (P>0.05). Conclusion: α-HBDH would be better than LDH in predicting the in-hospital death and postoperative cardiac injury, guiding admission stratification of patients with AAD.
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Zhao et al. (2023) conducted a cohort in Acute aortic dissection (n=369). High α-HBDH levels vs. Low α-HBDH levels was evaluated on In-hospital mortality and postoperative cardiac injury (OR 9.869, 95% CI 2.148-45.349, p=0.003). High α-HBDH levels on admission predicted in-hospital mortality and postoperative cardiac injury in patients with acute aortic dissection (OR 9.869; 95% CI 2.148-45.349; P=0.003).
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