Outcome Predictors in Patients Presenting With Acute Aortic Dissection.

Area of Science:

• Cardiology
• Endocrinology
• Vascular Surgery

Background:

• Acute aortic dissection (AAD) is a life-threatening condition with high mortality.
• Thyroid hormones play a crucial role in cardiovascular function.
• The specific role of thyroid hormones in AAD outcomes remains incompletely understood.

Purpose of the Study:

• To investigate the association between thyroid hormone levels, particularly triiodothyronine (T3), and in-hospital adverse events in patients with acute aortic dissection.
• To identify independent predictors of in-hospital mortality and acute renal failure in this patient cohort.

Main Methods:

• Retrospective analysis of 151 patients diagnosed with aortic dissection between January 2011 and May 2015 at a university-affiliated cardiac center.
• Evaluation of in-hospital mortality, acute renal failure, and other adverse events.
• Statistical analysis to determine independent predictors, including T3 levels, pericardial effusion, and dissection type.

Main Results:

• The in-hospital mortality rate was 12.6%.
• Lower T3 levels were observed in non-surviving patients compared to survivors (0.8±0.3 vs. 1.0±0.4 nmol/L, p<0.05).
• T3 independently predicted in-hospital mortality (HR 0.07) and acute renal failure (HR 0.22). Other predictors included pericardial effusion, conservative treatment, and Stanford type-A dissection.

Conclusions:

• Triiodothyronine (T3) is downregulated in patients with acute aortic dissection.
• Low T3 levels represent a significant risk factor for in-hospital death and acute renal failure in AAD patients.
• These findings suggest T3 may serve as a prognostic biomarker in acute aortic dissection.