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Outcomes of Uncomplicated Type B Intramural Hematoma Patients with Type 2 Diabetes Mellitus
  • +2
  • Qu Chen,
  • Dandan Jiang,
  • Feng Kuang,
  • Fan Yang,
  • Zhonggui Shan
Qu Chen
The First Affiliated Hospital of Xiamen University
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Dandan Jiang
The First Affiliated Hospital of Xiamen University
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Feng Kuang
The First Affiliated Hospital of Xiamen University
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Fan Yang
Xiamen University and Fujian Medical University Affiliated First Hospital
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Zhonggui Shan
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Abstract

Objectives We aimed to summarize the clinical presentation, therapeutic approaches, and outcomes of type B intramural hematoma (IMHB) patients with and without type 2 diabetes mellitus (DM). Methods Patients with uncomplicated IMHBs were included between January 2016 and January 2018 and divided into two groups according to whether they had DM or not. Cox proportional hazard analysis was utilized to investigate the risk factors of aortic-related mortality. Kaplan-Meier survival analysis with the log-rank test was used to estimate the cumulative mortality and aortic-related mortality. Results 149 patients were included and were divided into to two groups (DM group [n=60] and non-DM group [n=89]). Patients in the non-DM group underwent thoracic endovascular aortic repair (TEVAR) treatment more frequently (12% vs 2%, P=0.028) and had a higher reintervention rate during the follow-up (9 in 81 cases, 11% vs 2%, P=0.043). There were significant differences between the two groups regarding the aorta-related mortality rate during the acute phase (9% vs 0%, P=0.042) and the all-cause mortality rate (22% vs 7%, P=0.011). Ulcer-like projection (ULP) development (during the acute phase) (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.01-1.31, P=0.008), C-reactive protein (CRP) level (HR, 1.92; 95% CI, 1.51-2.49, P<0.001) and MMP-9 level (HR, 16.82; 95% CI, 7.52-28.71, P<0.001) were associated with an elevated risk for aorta-related mortality. Conclusions IMHBs without DM are not benign and have a considerably high aortic-related mortality rate. ULP development (during the acute phase), CRP levels and maximum MMP-9 are associated with an elevated risk for aorta-related mortality.