OPG/TRAIL ratio as a predictive biomarker of mortality in patients with type A acute aortic dissection.

Abstract

Following hospital discharge, patients with type A acute aortic dissection (TA-AAD) may present an increase in mortality risk. However, little is known about specific biomarkers associated with post-discharge survival, and there is a paucity of prognostic markers associated with TA-AAD. Here, we identify nine candidate proteins specific for patietns with TA-AAD in a cross-sectional dataset by unbiased protein screening and in-depth bioinformatic analyses. In addition, we explore their association with short-term and long-term mortality in a derivation cohort of patients with TA-AAD, including an internal (n = 300) and external (n = 236) dataset. An elevated osteoprotegerin (OPG)/tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) ratio was the strongest predictor of overall, 30-day, post-30-day mortality in both datasets and was confirmed to be a strong predictor of mortality in an independent validation cohort (n = 400). Based on OPG/TRAIL ratio-guided risk stratification, patients at high risk (>33) had a higher 1-year mortality (55.6% vs. 4.3%; 68.2% vs. 2.6%) than patients at low risk (<4) in both cohorts. In Conclusion, we show that an elevated OPG/TRAIL ratio is associated with a significant increase in short-term and long-term mortality in patients with TA-AAD.

• Authors: Jie Lu, Ping Li, Ke Ma, Yang Li, Hui Yuan, Junming Zhu, Weixun Duan, Jingsong Ou, Yonghong Huang, Long Wu, Xueliang Pan, Hui Zhang, Jie Du, Yulin Li
• Journal: Nature communications (Nat Commun) Vol. 12 Issue 1 Pg. 3401 (06 07 2021) ISSN: 2041-1723 [Electronic] England
• PMID: 34099729 (Publication Type: Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't, Validation Study)

Chemical References

• Biomarkers
• Osteoprotegerin
• TNF-Related Apoptosis-Inducing Ligand
• TNFRSF11B protein, human
• TNFSF10 protein, human

Topics

• Adult
• Aortic Dissection (blood, etiology, mortality, surgery)
• Aortic Aneurysm (blood, complications, mortality, surgery)
• Biomarkers (blood)
• Cross-Sectional Studies
• Datasets as Topic
• Disease-Free Survival
• Female
• Follow-Up Studies
• Hospital Mortality
• Humans
• Male
• Middle Aged
• Osteoprotegerin (blood)
• Patient Discharge
• Predictive Value of Tests
• Prospective Studies
• Risk Assessment (methods)
• TNF-Related Apoptosis-Inducing Ligand (blood)