Abstract
Partial thrombosis of the false lumen in uncomplicated type B aortic dissection (uTBAD) is associated with an increased late mortality risk. Whether the serum cortisol level can affect false lumen thrombosis in patients with uTBAD has not been well characterized. This study was performed on 87 patients with uTBAD. A curve-fitting method was used to analyze the relationship between serum cortisol and partial thrombosis of false lumen. Univariate and multivariate logistic regression analyses were used to identify false lumen partial thrombosis–associated serum cortisol. Curve-fitting’s result revealed a characteristic U shape, and 14.0 µg/dL was considered as the cutoff point for serum cortisol. The results of univariate and multivariate logistic regression analyses suggested that when trisecting the serum cortisol level into three parts, the low and high levels of serum cortisol could significantly affect the occurrence of false lumen partial thrombosis compared with the middle level. The odds ratio value of the low and high levels of serum cortisol was 6.12 and 4.65, respectively, in the univariate analysis, and 24.32 and 3.93, respectively, in the multivariate analysis. Low or high levels of serum cortisol might influence the natural result of uTBAD through affecting the false lumen thrombosis.
Highlights
Aortic dissection (AD) remains a catastrophic cardiovascular disease with increasing incidence, high mortality, and severe complications[1,2]
The results showed that patients with uncomplicated type B aortic dissection (uTBAD) having low or high level of serum cortisol presented more probability of the occurrence of false lumen partial thrombosis compared with the middle level
This was only a preliminary study. These results need to be replicated in more prospective studies to ensure whether they are stable and valid. This novel study revealed the relationship between serum cortisol level and partial thrombosis of false lumen in patients with uTBAD
Summary
Aortic dissection (AD) remains a catastrophic cardiovascular disease with increasing incidence, high mortality, and severe complications[1,2]. Patients with type B aortic dissection (TBAD) with partial false lumen thrombosis have been found to have an increased late mortality risk[7]. Cortisol impairs fibrinolytic capacity, upregulating the synthesis of plasminogen activator inhibitor type 1 These changes result in an impaired thrombin generation that has a prothrombotic effect[24]. The aim of this study was to evaluate the relationship between serum cortisol level and degree of false lumen thrombosis in patients with uTBAD without the thoracic endovascular aortic repair. It analyzed the serum cortisol level as a potential prognostic factor affecting the natural result of uTBAD
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