Peripheral Eosinophil Count Is Associated With the Prognosis of Patients With Type B Aortic Dissection Undergoing Endovascular Aortic Repair: A Retrospective Cohort Study.
Peripheral Eosinophil Count Is Associated With the Prognosis of Patients With Type B Aortic Dissection Undergoing Endovascular Aortic Repair: A Retrospective Cohort Study.
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外周嗜酸性粒细胞计数与接受血管内主动脉修复术的 B 型主动脉夹层患者的预后相关：一项回顾性队列研究
DOI：
10.1161/jaha.122.027339
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发表时间：
2022-12-06
影响因子：
5.4
通讯作者：
Jing, Zaiping
中科院分区：
文献类型：
--
作者：
Zhao, Kaiwen;Zhu, Hongqiao;Ma, Jiqing;Zhao, Zhiqing;Zhang, Lei;Zeng, Zan;Du, Pengcheng;Sun, Yudong;Yang, Qin;Zhou, Jian;Jing, Zaiping
嗜酸性粒细胞计数（EOS）已被提议提供多种心血管疾病的预后信息。然而，很少有研究者研究EOS对行胸腔内修复术的B型主动脉夹层患者的预测价值。作者回顾了在上海长海医院接受胸腔内修复术治疗的912例B型主动脉夹层患者的记录。采用受试者工作特征曲线分析，根据入院时EOS临界值分为2组（<7.4×106/L [n=505]和≥7.4×106/L [n=407]）。为了减少选择偏倚，应用倾向评分匹配。进行多变量回归分析和Kaplan-Meier曲线，以评估EOS与长期结局之间的相关性。此外，我们研究了EOS和结果之间的非线性相关性，使用一般的加性模型与限制三次样条。在匹配人群中，较低的EOS与显著较高的30天死亡率相关（4.1% vs 0%，P=0.007）。两组之间的30天不良事件无统计学差异（均P>0.05）。Kaplan-Meier分析显示，EOS <7.4×106/L的患者1年全因死亡（7.95% vs 2.34%，P=0.008）和主动脉相关死亡（5.98% vs 1.81%，P=0.023）的发生率高于EOS较高的患者。多变量考克斯分析显示，连续EOS与1年死亡率独立相关（风险比，3.23 [95% CI，1.20-8.33]，P=0.019）。此外，我们发现EOS与1年结局之间存在非线性相关性。较低的入院EOS值预测胸腔腔内修复术后的短期和长期死亡率较高。
Eosinophil count (EOS) has been proposed to provide prognostic information in multiple cardiovascular disorders. However, few researchers have investigated the predictive value of EOS for patients with type B aortic dissection who had thoracic endovascular repair. The authors reviewed the records of 912 patients with type B aortic dissection who were treated with thoracic endovascular repair in Changhai Hospital, Shanghai. By using receiver operating characteristic curve analysis, patients were divided into 2 groups based on the admission EOS cutoff value (<7.4×106/L [n=505] and ≥7.4×106/L [n=407]). To reduce selection bias, propensity score matching was applied. Multivariable regression analysis and Kaplan–Meier curves were performed to assess the association between EOS and long‐term outcomes. Furthermore, we investigated nonlinear correlations between EOS and outcomes using general additive models with restricted cubic splines. In the matched population, lower EOS was associated with significantly higher 30‐day mortality (4.1% vs 0%, P=0.007). There was no statistically difference in 30‐day adverse events between the 2 groups (all P>0.05). Kaplan–Meier analysis revealed that patients with an EOS <7.4×106/L had a higher incidence of 1‐year all‐cause death (7.95% vs. 2.34%, P=0.008) and aortic‐related death (5.98% vs 1.81%, P=0.023) than those with higher EOS. Multivariable Cox analysis showed that continuous EOS was independently associated with 1‐year mortality (hazard ratio, 3.23 [95% CI, 1.20–8.33], P=0.019). In addition, we discovered a nonlinear association between EOS and 1‐year outcomes. Lower admission EOS values predict higher short‐ and long‐term mortality after thoracic endovascular repair.