Early prediction of prognosis of acute type A aortic dissection by lipoprotein-associated phospholipase A2: A prospective cohort study
- VernacularTitle:脂蛋白相关磷脂酶A2早期预测急性A型主动脉夹层预后的前瞻性队列研究
- Author:
Yongsheng NIU
1
;
Shuai NIE
1
;
Fuhua HUANG
2
;
Xinwei MU
1
;
Cui ZHANG
1
Author Information
1. Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, P.R.China
2. Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, P.R.China
- Publication Type:Journal Article
- Keywords:
Aortic dissection;
lipoprotein-associated phospholipase A2;
inflammatory response;
prognosis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(09):1031-1036
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and in-hospital prognosis in patients with acute type A aortic dissection within 24 hours of admission. Methods Fortysix patients diagnosed with type A aortic dissection were included in our hospital and their Lp-PLA2 levels within 24 hours of admission were measured between January 2017 and June 2019. According to their Lp-PLA2 levels within 24 hours of admission, 23 patients were classified into a high Lp-PLA2 group (Lp-PLA2 > 200 μg/L, 16 males and 7 females at age of 52.0±14.0 years) and 23 patients were into a low Lp-PLA2 group (Lp-PLA2 ≤200 μg/L, 15 males and 8 females at age of 53.0±11.0 years). The relationship between Lp-PLA2 level and clinical outcome was analyzed. Results The incidences of bleeding, hospital infection, multiple organ dysfunction and mortality in the high Lp-PLA2 group were higher than those in the low Lp-PLA2 group (P<0.05). Seven (15.2%) patients died during 3 months of follow-up. The 3-month survival rate of patients with an increase of Lp-PLA2 was significantly lower than that of the patients with normal Lp-PLA2 (P<0.01), which was an independent predictor of adverse outcomes at 3 months of onset (P<0.01). Conclusion Lp-PLA2 may be a predictor of disease progression in the patients with acute type A aortic dissection, and the patients with significantly elevated Lp-PLA2 have a higher 3-month mortality than the patients with normal Lp-PLA2.
