P158. Impact of Preoperative Hyperuricemia on the Prognosis of Patients with Acute Type A Aortic Dissection
Beijing Anzhen Hospital Capital Medical University
Beijing
China - Contact Me
Songhao Jia received a Bachelor of Medicine degree from Capital Medical University, Beijing, China, in 2021. He is currently working toward the M.D. degree in cardiovascular surgery with the Beijing Anzhen Hospital, Capital Medical University, Beijing, China. His main research direction is surgical treatment of aortic dissection. So far, he has published 5 SCI papers as the first author and obtained 2 patents. His research achievements were invited to report at academic conferences such as the 24th Congress of the Chinese Society of Cardiology, the China Endovascular course, and the Great Wall Cardiology Conference, and served as the reviewer of Cardiovascular Innovations and Applications.
Scientific Publication:
1. Jia S, Wang M, Liu Y, Gong M, Jiang W, Zhang H. Effect of Asymptomatic Common Carotid Artery Dissection on the Prognosis of Patients With Acute Type A Aortic Dissection. J Am Heart Assoc. 2024;13(1): e031542. ( IF:5.4 )
2. Jia S, Wang M, Gong M, Zhang H, Jiang W. Midterm outcomes of simultaneous carotid revascularization combined with coronary artery bypass grafting. BMC Cardiovasc Disord. 2022 Dec 8;22(1):535. (IF:2.1)
3. Jia S, Han J, Jiang W, Zhang H. Triple valve repair for a patient with complex rheumatic-heart valvular disease: A case report. Asian J Surg. 2023 Nov;46(11):5043-5045. (IF:3.5)
4. Wang M†, Jia S†, Pu X, Sun L, Gong M*, Zhang H*. Mid-term Patency of the Great Saphenous Bypass to Aorta vs. Non-aortic Arteries in Stanford Type A Aortic Dissection Surgery With Concomitant CABG. Front Cardiovasc Med. 2021 Oct 26;8:743562. (IF:3.6)
5. Wang M†, Jia S†, Pu X, Sun L, Liu Y*, Gong M*, Zhang H*. A scoring model based on clinical factors to predict postoperative moderate to severe acute respiratory distress syndrome in Stanford type A aortic dissection. BMC Pulm Med. 2023 Dec 21;23(1):515. (IF: 3.1)
Description
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.
Authors
Songhao Jia (1), Wenjian Jiang (1), Hongjia Zhang (1)
Institutions
(1) Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China