Serum Folic Acid Predicted Pre-Operative Aortic Rupture in Symptomatic Aortic Aneurysm Dissection: A Prospective,...

Area of Science:

• Cardiovascular Medicine
• Biochemistry

Background:

• Folate metabolites are established prognostic markers in various diseases.
• Limited research exists on the association between serum folic acid and aortic rupture.
• Symptomatic aortic aneurysm/dissection patients require better pre-operative risk assessment.

Purpose of the Study:

• To investigate the predictive value of serum folic acid levels for pre-operative adverse events.
• To evaluate serum folic acid as a predictor of aortic rupture in patients with symptomatic aortic aneurysm/dissection.

Main Methods:

• Prospective enrollment of 639 patients with symptomatic aortic aneurysm/dissection in the emergency department.
• Univariate and multivariate logistic regression analyses to identify rupture predictors.
• Development of a prognostic nomogram incorporating folic acid levels and other clinical markers.

Main Results:

• 8.61% of patients experienced pre-operative aortic rupture, with higher incidence in those with elevated serum folic acid.
• Serum folic acid levels ≥9 ng/mL were an independent risk factor for pre-operative aortic rupture (OR=2.41).
• A nomogram combining aortic dissection type, folic acid, WBC, potassium, and glucose showed strong predictive ability (AUC=0.801).

Conclusions:

• Serum folic acid level is an independent predictor of pre-operative aortic rupture in symptomatic aortic aneurysm/dissection patients.
• The developed nomogram provides a practical tool for early risk stratification in emergency settings.
• Folic acid's prognostic value, alongside other clinical markers, aids in managing high-risk cardiovascular patients.