Clinical efficacy of intensive conservative treatment for acute aortic syndrome
10.3760/cma.j.cn112434-20250129-00027
- VernacularTitle:急性主动脉综合征强化保守治疗临床疗效研究
- Author:
Yinfan ZHU
1
;
Lu DAI
;
Haotian WU
;
Yamin LI
;
Dongjie LI
;
Shipan WANG
;
Jiajun LIANG
;
Yan YAN
;
Jianjun GAO
;
Yeting LOU
;
Zhenze TAO
;
Yifan LU
;
Zhiran YANG
;
Jia LI
;
Siji CHEN
;
Chuang LIU
;
Yazhe ZHANG
;
Yuhong MI
;
Haiyang LI
;
Wenjian JIANG
;
Hongjia ZHANG
Author Information
1. 首都医科大学附属北京安贞医院心脏外科，北京 100029
- Publication Type:Journal Article
- Keywords:
Acute aortic syndrome;
Aortic dissection;
Intensive conservative treatment
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2025;41(3):143-150
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the outcomes of intensive conservative treatment compared to conventional conservative treatment in patients with acute aortic syndrome(AAS).Methods:The study prospectively enrolled consecutive patients with AAS who were admitted to Beijing Anzhen Hospital, affiliated with Capital Medical University, and Beijing Dawanglu Emergency Rescue Hospital from January 2024 to December 2024. These patients with surgical contraindications or refused surgery for various reasons opted for conservative treatment. A total of 282 patients were included, and 15 patients with missing data or those who died without any treatment were excluded. Finally, 267 patients were enrolled, of whom 94 received intensive conservative treatment, and 173 received conventional conservative treatment, the inverse probability of treatment weighting (IPTW) was used to reduce the influence of confoundings. After adjusting of baseline datas via IPTW, the survival outcomes of the two groups were compared at 14 days, 30 days, and at the end of follow-up.Results:The results showed significant differences in acute phase survival rates between the enhanced conservative treatment group and the conventional conservative treatment group at 14 days(82.40%vs.53.20%, P<0.0001). Significant survival differences were also observed at 30 days and at 276-day mid-term follow-up (96.29% vs.51.60%, P<0.0001; 78.50% vs.48.50%, P<0.0001). In the subgroup analysis, for type A aortic dissection, the enhanced conservative treatment group had higher survival rates compared to the conventional conservative treatment group at 14, 30 and 276 days (63.46% vs.41.35%, P<0.05; 52.17% vs.37.90%, P<0.05; 50.00% vs. 31.97%, P<0.05). However, for type B aortic dissection, although the enhanced conservative treatment group had higher survival rates than the conventional conservative treatment group, no statistically significant differences were observed (96.29% vs. 80.00%, P=0.054; 95.65% vs.78.37%, P=0.067; 94.12% vs.74.20%, P=0.088). Conclusion:For patients diagnosed with AAS are forced to choose conservative treatment if emergency surgery is not possible in the first place, intensive conservative treatment strategies can significantly reduce the mortality in the acute phase compared with conventional conservative treatment. Mid-term follow-up, intensive conservative treatment still has a significant survival advantage.
