Inflammatory profiles define phenotypes with clinical relevance in acute type A aortic dissection

Area of Science:

• Cardiovascular Medicine
• Immunology
• Medical Statistics

Background:

• The relationship between specific inflammatory profiles and short-term mortality in type A aortic dissection (TAAD) is not well understood.
• TAAD is a life-threatening condition requiring accurate prognostic markers.

Purpose of the Study:

• To identify distinct inflammatory profiles in patients with TAAD using latent class analysis.
• To investigate the association between these identified inflammatory profiles and short-term mortality (30-day and 6-month).

Main Methods:

• Latent class analysis was employed to categorize patients based on inflammatory markers: leukocyte, neutrophils, monocyte, lymphocytes, platelet, fibrinogen, D-dimer, and calculated ratios (neutrophils-lymphocyte, platelet-lymphocyte, lymphocyte-monocyte).
• A cohort of 193 TAAD patients was analyzed, divided into hyper-inflammatory and hypo-inflammatory groups.
• Mortality rates at 30 days and 6 months were compared between the groups, with adjustments for potential confounders.

Main Results:

• Two distinct inflammatory profiles were identified: hyper-inflammatory (43.5%) and hypo-inflammatory (56.5%).
• Hyper-inflammatory patients exhibited significantly higher 30-day (21.4% vs. 8.3%) and 6-month (23.8% vs. 10.1%) mortality rates compared to hypo-inflammatory patients.
• After adjusting for confounders, hyper-inflammatory profiles remained a significant predictor of increased 6-month mortality (adjusted OR 2.427).

Conclusions:

• Preoperative assessment of inflammatory profiles provides valuable insights into the inflammatory response in TAAD.
• The identified hyper-inflammatory profile is associated with a substantially higher risk of short-term mortality in TAAD patients.
• These findings suggest the potential for individualized anti-inflammatory pharmacotherapy in managing TAAD.