Serum Beta-Hydroxybutyrate as a Biomarker for Predicting Major Adverse Cardiovascular Events After Type a Aortic...

Area of Science:

• Cardiovascular Surgery
• Metabolic Research
• Biomarker Discovery

Background:

• Acute type A aortic dissection (ATAAD) is a critical condition with frequent postoperative major adverse cardiovascular events (MACE).
• Predictive biomarkers for MACE in ATAAD patients are currently insufficient.
• This study investigates serum beta-hydroxybutyrate (β-OHB) as a prognostic marker for MACE post-ATAAD surgery.

Purpose of the Study:

• To evaluate the prognostic value of preoperative serum β-OHB levels in predicting MACE after ATAAD surgery.
• To assess β-OHB's efficacy compared to established biomarkers for MACE prediction.
• To determine the association between β-OHB levels and postoperative outcomes, including mortality and length of stay.

Main Methods:

• Retrospective analysis of 728 patients who underwent surgical repair for ATAAD.
• Stratification of patients based on preoperative serum β-OHB levels.
• Primary endpoint: in-hospital MACE (mortality, MI, heart failure, reoperation, stroke); Secondary endpoints: 30-day mortality, ICU/hospital stay duration.

Main Results:

• Elevated β-OHB independently predicted higher MACE risk (aOR: 8.314) and 30-day mortality (aHR: 2.316).
• ROC analysis indicated β-OHB (AUC: 0.781) was comparable to BNP and D-dimer in predicting MACE.
• Higher β-OHB levels correlated with increased MACE incidence and decreased 30-day survival.

Conclusions:

• Serum β-OHB serves as a novel metabolic biomarker for risk stratification in ATAAD patients.
• β-OHB demonstrates potential clinical utility in guiding perioperative decision-making for ATAAD.
• This finding highlights the role of metabolic markers in predicting outcomes for acute aortic dissections.