Prognostic Value of Preoperative Hemoglobin Levels for Long-Term Outcomes of Acute Type B Aortic Dissection Post-thoracic Endovascular Aortic Repair.
Prognostic Value of Preoperative Hemoglobin Levels for Long-Term Outcomes of Acute Type B Aortic Dissection Post-thoracic Endovascular Aortic Repair.
复制标题
术前血红蛋白水平对急性 B 型主动脉夹层胸腔内主动脉修复术后长期结果的预后价值。
DOI：
10.3389/fcvm.2020.588761
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发表时间：
2020
影响因子：
3.6
通讯作者：
Jin J
中科院分区：
文献类型：
--
作者：
Gao Z;Qin Z;An Z;Hou C;Wang L;Jin J
背景和目标：关于术前血红蛋白（Hb）水平对胸主动脉腔内修复术（TEVAR）后急性B型主动脉夹层（ABAD）长期结局的预后价值，现有信息很少。研究方法：对2010年至2018年的连续患者进行了关于Hb水平与长期结局之间关系的回顾性分析。主要终点为全因死亡率。主要不良心血管事件（MACE）包括全因死亡、复发性破裂和二次手术。结果：共入组了391例接受TEVAR治疗的受试者，平均年龄为57.1 ± 12.0岁;其中79.5%为男性。考克斯多变量分析显示，术前Hb水平与全因死亡[校正的风险比（HR）0.797（每1 g/dl），95%置信区间（CI）0.693-0.918，p = 0.002]和MACE（校正的HR 0.795，95% CI 0.672-0.871，p = 0.000）独立相关。全因死亡和MACE的Hb受试者工作特征曲线下面积分别为0.617（95% CI 0.548-0.687，p = 0.008）和0.617（95% CI 0.551-0.684，p = 0.005）。在线性趋势检验中，Hb浓度与全因死亡率（趋势p = 0.001）和MACE（趋势p = 0.000）显著相关。此外，在Kaplan-Meier分析中，对于全因死亡（对数秩p = 0.001）和MACE（对数秩p = 0.001），较低Hb水平（<12 g/dl）与较高Hb水平（≥12 g/dl）存在显著差异。在评估红细胞计数和贫血的预后价值时，也发现了类似的结果。结论：术前Hb可作为TEVAR后ABAD患者长期不良结局的预后指标。
Background and Aims: There is scant information available about the prognostic value of preoperative hemoglobin (Hb) levels on the long-term outcomes of acute type B aortic dissection (ABAD) following thoracic endovascular aortic repair (TEVAR). Methods: A retrospective analysis of consecutive patients from 2010 to 2018 regarding the relationship between Hb level and long-term outcomes was conducted. The primary endpoint was all-cause mortality. Major adverse cardiovascular events (MACEs) included all-cause death, recurrent ruptures, and secondary procedures. Results: In total, 391 subjects treated by TEVAR were enrolled, with a mean age of 57.1 ± 12.0 years; 79.5% of them were male. Cox multivariate analysis showed that the preoperative Hb level was independently associated with all-cause death [adjusted hazard ratio (HR) 0.797 (per 1 g/dl), 95% confidence interval (CI) 0.693–0.918, p = 0.002] and MACEs (adjusted HR 0.795, 95% CI 0.672–0.871, p = 0.000). The area under the receiver operating characteristic curve of Hb for all-cause death and MACEs were 0.617 (95% CI 0.548–0.687, p = 0.008) and 0.617 (95% CI 0.551–0.684, p = 0.005), respectively. In the linear trend test, Hb concentration was significantly related to all-cause mortality (p for trend = 0.001) and MACEs (p for trend = 0.000). Moreover, in Kaplan–Meier analysis, lower Hb levels (< 12 g/dl) were significantly different from higher Hb (≥12 g/dl) levels for both all-cause death (log-rank p = 0.001) and MACEs (log-rank p = 0.001). Similar results were found when assessing the prognostic value of red blood cell count and anemia. Conclusions: Preoperative Hb may serve as a prognostic marker for long-range adverse outcomes for ABAD patients post-TEVAR.
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影响因子：
8
作者：
Cattadori, Gaia;Agostoni, Piergiuseppe;Piepoli, Massimo F.
通讯作者：
Piepoli, Massimo F.
影响因子：
5.3
作者：
Grammer, Tanja B.;Kleber, Marcus E.;Maerz, Winfried
通讯作者：
Maerz, Winfried
影响因子：
24
作者：
Lee, PC;Kini, AS;Sharma, SK
通讯作者：
Sharma, SK
影响因子：
39.3
作者：
Erbel, Raimund;Aboyans, Victor;Vrints, Christiaan J. M.
通讯作者：
Vrints, Christiaan J. M.
影响因子：
0.9
作者：
Gorla, Riccardo;Tsagakis, Konstantinos;Janosi, Rolf Alexander
通讯作者：
Janosi, Rolf Alexander