loading page

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

Abstract

Objectives We aimed to summarize the clinical presentations, 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 or not they had DM. Cox proportional hazard analysis was utilized to investigate the risk factors for aortic-related mortality. Kaplan-Meier survival analysis was used to estimate cumulative mortality and aortic-related mortality. Results A total of 149 patients were included and were divided into the two groups (DM group [n=60] and non-DM group [n=89]). Patients in the non-DM group underwent thoracic endovascular aortic repair treatment more frequently (12% vs 2%, P=0.028) and had a higher reintervention rate during the follow-up (9 in 81 patients, 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) levels (HR, 1.92; 95% CI, 1.51-2.49, P<0.001) and MMP-9 levels (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 levels are associated with an elevated risk for aorta-related mortality.

Peer review status:ACCEPTED

14 Nov 2020Submitted to Journal of Cardiac Surgery
19 Nov 2020Submission Checks Completed
19 Nov 2020Assigned to Editor
23 Nov 2020Reviewer(s) Assigned
06 Dec 2020Review(s) Completed, Editorial Evaluation Pending
07 Dec 2020Editorial Decision: Revise Major
15 Dec 20201st Revision Received
16 Dec 2020Submission Checks Completed
16 Dec 2020Assigned to Editor
16 Dec 2020Reviewer(s) Assigned
31 Dec 2020Review(s) Completed, Editorial Evaluation Pending
04 Jan 2021Editorial Decision: Accept