PMID- 32652723
OWN - NLM
STAT- MEDLINE
DCOM- 20200810
LR  - 20200810
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 35
IP  - 8
DP  - 2020 Aug
TI  - Outcomes of type A intramural hematoma: Influence of diabetes mellitus.
PG  - 1811-1821
LID - 10.1111/jocs.14812 [doi]
AB  - OBJECTIVES: We aimed to investigate whether uncomplicated type A intramural 
      hematoma (IMHA) patients with type 2 diabetes mellitus (DM) who underwent a 
      "wait-and-watch strategy" and tight glycemic control had similar clinical 
      outcomes as patients without DM who received the same treatment strategy. 
      METHODS: Between January 2010 and December 2016, uncomplicated IMHA patients with 
      and without diabetes mellitus were included and were propensity score-matched to 
      improve the balance between the two groups. Cox proportional hazard models were 
      constructed to identify the specific factors associated with aorta-related 
      mortality. The Fine-Gray model for the competing risk analysis was used to 
      estimate the aorta-related and nonaorta-related mortality in different groups 
      during the follow-up period. RESULTS: A total of 109 IMHA patients were included 
      in this study, and 66 patients were included after matching. Patients without DM 
      experienced significantly more aorta-related adverse events (51.6% vs 13.3%; 
      P = .001) and reinterventions than patients in the DM group (29.0% vs 6.7%; 
      P = .023). Cox regression analysis revealed that a higher matrix 
      metalloproteinase-9 level (hazard ratio [HR], 1.70; 95% confidence interval [CI], 
      1.39-2.09; P < .001) and larger maximum aortic diameter (HR, 1.41; 95% CI, 
      1.11-1.80; P = .005) were associated with higher aorta-related mortality. The 
      competing risk analysis revealed a significantly higher aorta-related mortality 
      during the follow-up period in the no DM group than in the DM group (36.4%; 95% 
      CI, 11.6%-82.3%; P = .0294). CONCLUSIONS: Uncomplicated IMHA patients with DM 
      (receiving the "wait-and-watch strategy" and tight glycemic control) may have 
      lower aorta-related mortality and rates of aorta-related adverse events and 
      reinterventions than the no DM group.
CI  - (c) 2020 Wiley Periodicals LLC.
FAU - Chen, Qu
AU  - Chen Q
AUID- ORCID: 0000-0002-5417-2620
AD  - Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen 
      University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, 
      China.
FAU - Jiang, Dandan
AU  - Jiang D
AD  - Department of Internal Medicine, Xinglin Branch of The First Affiliated Hospital 
      of Xiamen University, Teaching Hospital of Fujian Medical University, Xiamen, 
      Fujian, China.
FAU - Kuang, Feng
AU  - Kuang F
AD  - Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen 
      University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, 
      China.
FAU - Yang, Fan
AU  - Yang F
AD  - Department of Radiology, The First Affiliated Hospital of Xiamen University, 
      Teaching Hospital of Fujian Medical University, Xiamen, Fujian, China.
FAU - Shan, Zhonggui
AU  - Shan Z
AUID- ORCID: 0000-0003-3638-3640
AD  - Department of Cardiovascular Surgery, The First Affiliated Hospital of Xiamen 
      University, Teaching Hospital of Fujian Medical University, Xiamen, Fujian, 
      China.
LA  - eng
PT  - Journal Article
DEP - 20200711
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
RN  - EC 3.4.24.35 (Matrix Metalloproteinase 9)
SB  - IM
MH  - Aorta/pathology
MH  - Aortic Diseases/*etiology/mortality/prevention & control
MH  - Diabetes Mellitus, Type 2/*complications/drug therapy
MH  - Follow-Up Studies
MH  - Glycemic Index
MH  - Hematoma/*complications
MH  - Humans
MH  - Matrix Metalloproteinase 9
MH  - Propensity Score
MH  - Proportional Hazards Models
MH  - Risk
OTO - NOTNLM
OT  - IMH
OT  - diabetes mellitus
OT  - outcome
EDAT- 2020/07/12 06:00
MHDA- 2020/08/11 06:00
CRDT- 2020/07/12 06:00
PHST- 2020/04/28 00:00 [received]
PHST- 2020/05/18 00:00 [revised]
PHST- 2020/05/19 00:00 [accepted]
PHST- 2020/07/12 06:00 [pubmed]
PHST- 2020/08/11 06:00 [medline]
PHST- 2020/07/12 06:00 [entrez]
AID - 10.1111/jocs.14812 [doi]
PST - ppublish
SO  - J Card Surg. 2020 Aug;35(8):1811-1821. doi: 10.1111/jocs.14812. Epub 2020 Jul 11.