Chen Lingzhi1, Zhou Hao2, Huang Weijian2, Zheng Gaoshu2, Sun Chengchao3, Chen Changxi2, Zhao Chuhuan2, Gao Zhan4. 1. Department of Clinical Laboratory, Wenzhou Central Hospital, Wenzhou, Zhejiang Province, China; 2. Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China. 3. Thoracic Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China. 4. Cardiology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China. Electronic address: lyonx@126.com.
Abstract
OBJECTIVE: To investigate the role of thyroid hormones and other factors in acute aortic dissection and an association with in-hospital adverse events. DESIGN: A retrospective analysis. SETTING: A university-affiliated cardiac center. PARTICIPANTS: A total of 151 patients with aortic dissection admitted to the authors' hospital between January 2011 and May 2015. INTERVENTION: None. MEASUREMENTS AND RESULTS: The total in-hospital mortality rate was 12.6%. Triiodothyronine (T3) level was lower in nonsurviving than surviving patients (0.8±0.3 v 1.0±0.4 nmol/L, p<0.05). T3 independently predicted in-hospital mortality (hazard ratio [HR] 0.07, 95% CI 0.01-0.43, p<0.01) and in-hospital acute renal failure (HR 0.22, 0.05-0.89, p<0.05) for all patients. Other independent predictors of in-hospital mortality were pericardial effusion (HR 8.18, 2.11-31.67, p<0.01), conservative treatment (HR 82.12, 12.49-540.09, p<0.01) and Stanford type-A aortic dissection (HR 3.86, 1.06-14.09, p<0.05). Inpatient conservative treatment, T3 (HR 0.01, 0.00-0.18, p<0.01) as well as pericardial effusion (HR 11.80, 2.46-56.59, p<0.01), Stanford type-A dissection (HR 22.35, 3.15-158.40, p<0.01), and in-hospital acute renal failure (HR 16.95, 2.04-140.86, p<0.01) were predictors for in-hospital mortality. In nonconservatively treated patients, T3 (HR 0.02, 0.00-0.88, p<0.05) as well as cardiac care unit stay (HR 0.74, 0.59-0.94, p<0.01) and postoperative acute renal failure (HR 21.32, 3.07-147.88, p<0.01) were predictors for in-hospital mortality. CONCLUSION: T3 was downregulated in acute aortic dissection. Low T3 level was a risk factor for in-hospital death and acute renal failure in patients with acute aortic dissection.
OBJECTIVE: To investigate the role of thyroid hormones and other factors in acute aortic dissection and an association with in-hospital adverse events. DESIGN: A retrospective analysis. SETTING: A university-affiliated cardiac center. PARTICIPANTS: A total of 151 patients with aortic dissection admitted to the authors' hospital between January 2011 and May 2015. INTERVENTION: None. MEASUREMENTS AND RESULTS: The total in-hospital mortality rate was 12.6%. Triiodothyronine (T3) level was lower in nonsurviving than surviving patients (0.8±0.3 v 1.0±0.4 nmol/L, p<0.05). T3 independently predicted in-hospital mortality (hazard ratio [HR] 0.07, 95% CI 0.01-0.43, p<0.01) and in-hospital acute renal failure (HR 0.22, 0.05-0.89, p<0.05) for all patients. Other independent predictors of in-hospital mortality were pericardial effusion (HR 8.18, 2.11-31.67, p<0.01), conservative treatment (HR 82.12, 12.49-540.09, p<0.01) and Stanford type-A aortic dissection (HR 3.86, 1.06-14.09, p<0.05). Inpatient conservative treatment, T3 (HR 0.01, 0.00-0.18, p<0.01) as well as pericardial effusion (HR 11.80, 2.46-56.59, p<0.01), Stanford type-A dissection (HR 22.35, 3.15-158.40, p<0.01), and in-hospital acute renal failure (HR 16.95, 2.04-140.86, p<0.01) were predictors for in-hospital mortality. In nonconservatively treated patients, T3 (HR 0.02, 0.00-0.88, p<0.05) as well as cardiac care unit stay (HR 0.74, 0.59-0.94, p<0.01) and postoperative acute renal failure (HR 21.32, 3.07-147.88, p<0.01) were predictors for in-hospital mortality. CONCLUSION:T3 was downregulated in acute aortic dissection. Low T3 level was a risk factor for in-hospital death and acute renal failure in patients with acute aortic dissection.