ArticleReviews in cardiovascular medicine2025
Coagulation Disorders in Patients With Acute Respiratory Distress Syndrome Following Acute Aortic Dissection: A Prospective Observational Study.
Article in Reviews in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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10 authors.
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Abstract
Background: Coagulation disorders are potentially one of the most important pathogeneses of acute respiratory distress syndrome (ARDS) following acute type A aortic dissection (ATAAD). This study aimed to determine whether aortic dissection singularly and cardiopulmonary bypass (CPB) surgery can activate coagulation pathways, promoting ARDS development in patients with ATAAD. Methods: A total of 450 patients who received treatment at Beijing Anzhen Hospital, Capital Medical University, between March 2023 and February 2024 were consecutively enrolled in this prospective cohort study. We analyzed the clinical factors and measured serum coagulation biomarkers by enzyme-linked immunosorbent assay (ELISA) among patients with ATAAD, aortic aneurysm (AA), or unstable angina (UA). Logistic regression, two-way analysis of variance (ANOVA), and Spearman's correlation analysis were performed. Furthermore, the patients with ATAAD were divided into ARDS (based on chest radiographic findings and an oxygenation index ≤300 mmHg) and non-ARDS groups for subgroup comparisons. Results: The incidence of postoperative ARDS among patients with ATAAD was 20.7% (13.3% in the AA group and 7.3% in the UA group). Preoperatively, prothrombin time (PT) was longer in patients with ATAAD than in those with AA or UA ((odds ratio (OR): 12.0, 95% confidence interval (CI): 11.5-12.6) vs. (OR: 11.4, 95% CI: 10.9-12.1) vs. (OR: 11.2, 95% CI: 10.8-11.6), respectively; Conclusion: Coagulation activation may be caused by aortic dissection singularly and CPB, which promotes postoperative ARDS in patients with ATAAD.
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