Impact of preoperative hyperuricemia on the prognosis of patients with acute type A aortic dissection

P0158 

Abstract Submission 

Songhao Jia (1), Wenjian Jiang (1), Hongjia Zhang (1)

(1) Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

Songhao Jia    -  Contact Me
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University

Wenjian Jiang    -  Contact Me
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University

Hongjia Zhang    -  Contact Me
Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University

Songhao Jia    -  Contact Me
N/A

Objective: Our research aims to explore the impact of preoperative hyperuricemia on the prognosis of patients with acute type A aortic dissection.
Method: Between January 2015 and December 2017, 485 patients with acute type A aortic dissection who underwent surgery were included in our study. Based on preoperative blood uric acid tests, the patients were divided into a hyperuricemia group (N=118) and a normal uric acid group (N=367). Cox regression model was used to determine predictors of mortality. Multivariable adjustment and stabilized inverse probability of treatment weighting (IPTWs) were used to adjust for confounders.
Result: 118 patients (24.3%) developed hyperuricemia before surgery, and after using IPTWs to adjust baseline data, all variables in both groups had good balance (SMD<0.1). The 30-day mortality (19.4% vs 6.2%, P<0.001), ICU time (2.5d vs 1.9d, P=0.024), and ventilator time (76.0h vs 42.0h, P=0.004) in the hyperuricemia group were significantly higher than those in the normal uric acid group. Univariate and multivariate COX regression revealed that preoperative hyperuricemia was an independent risk factor for 30-day mortality in patients (HR, 2.2; 95% CI, 1.2-4.1; P=0.016). In subgroup analysis based on different age, gender, smoking, hypertension, ascending aorta replacement, and root replacement, the trend of increased mortality in the preoperative hyperuricemia group was consistent, and no interaction was found. In a median follow-up time of 6.2 years (IQR, 5.6-6.9 years), Landmark analysis using postoperative 1 month as the threshold showed that the mortality of the hyperuricemia group mainly increased significantly within 1 month after surgery (Log rank P<0.001), and there was no significant difference in survival between the two groups after 1 month (Log rank P=0.506).
Conclusion: Preoperative hyperuricemia was an independent risk factor for early mortality in patients with acute type A aortic dissection, but it did not affect the mid-term survival in patients who survived the early postoperative period.

Dissection