Prognostic Value of Serum Erythropoietin Levels in Acute Aortic Syndrome: A Real-World Analysis

It is currently unclear whether erythropoietin (EPO) has value in predicting the prognosis of acute aortic syndrome (AAS).

A real-world analysis was conducted on the relationship between EPO and AAS outcomes. The primary end points were all-cause mortality and aortic-related mortality. The major adverse cardiac and cerebral events included all-cause mortality, acute myocardial infarction, stroke, and secondary procedures. Serum EPO concentration was examined using the Quantikine Human EPO ELISA.

A total of 254 AAS patients were recruited, of whom 73 died. The median time of follow-up was 18.1 months. In Cox regression analysis, log EPO (hazard ratio [HR]: 2.491, P < 0.001), Stanford type A (HR: 3.003, P < 0.001), and treatment with surgery/thoracic endovascular aortic repair (TEVAR; HR: 0.283, P < 0.001) were independent predictors of all-cause mortality. In Kaplan-Meier curves, patients with EPO ≤16 IU/mL had significantly higher survival and event-free rates. Nomograms indicated that log EPO had the greatest contribution to AAS prognosis. In subgroup analysis, log EPO was an important prognostic indicator for patients with type A AAS and those treated without surgery/TEVAR. In correlation analyses, EPO was positively correlated with C-reactive protein, interleukin (IL)-4, IL-6, and monocytes and negatively correlated with albumin. The maximum diameter of the ascending aorta was positively correlated with EPO in AAS and aortic dissection (AoD) patients. The false lumen diameter and false lumen area were positively correlated with EPO in AoD patients.

The serum EPO level is closely associated with the adverse outcomes of AAS and has good prognostic value.