title: Time-dependent changes of plasma inflammatory biomarkers in type A aortic dissection patients without optimal medical management.
abstract: OBJECTIVE
  To investigate the time-dependent changes in plasma levels of interleukin-6, C-reactive protein, and tumor necrosis factor-α in patients with type A aortic dissection (TAAD) who received unoptimal medical management since the onset of dissections.
  
  
  METHODS
  Plasma levels of interleukin-6, C-reactive protein, and tumor necrosis factor-α were detected by ELISA and immuno-turbidimetric assay in 92 TAAD patients at hospital admission. Blood samples from 78 patients with uncontrolled hypertension and 82 healthy volunteers were also analyzed as controls. The occurrence of TAAD-related complication and its relationship with the plasma levels of these inflammatory biomarkers was also investigated.
  
  
  RESULTS
  The concentrations of inflammatory mediators were significant higher in TAAD than those in the uncontrolled hypertension and the healthy group. The time to peak plasma level of IL-6.and TNF-α was shorter than that of CRP in TAAD group. In the TAAD group, 51 patients suffered TAAD-related complications, and their plasma level of CRP was significantly higher than that in patients without TAAD-related complications (94.5 ± 58.8 mg/L versus 47.4 ± 47.8 mg/L, p < 0.001). Also, CRP levels strongly correlated with the value of PaO2/FiO2 ratio (r = -0.69, p < 0.001) and creatinine (r = 0.60, p < 0.001). The time to the peak level of CRP was shorter and the duration of persistently high CRP level was longer in the complication group than those in the complication-free group.
  
  
  CONCLUSIONS
  Elevated and persistently high levels of plasma CRP, IL-6 and TNF-α were associated with progressively development of the TAAD. The changing pattern of CRP might be a marker for diagnosis and prophylactic treatment of complications. Our findings suggested a critical role of the inflammation in the progression of dissection and TAAD-related complications.
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. doctorgujun@gmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Gu
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. humanjia@msn.com.
authors.forename: Jia
authors.initials: J
authors.lastname: Hu
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. hxzhanghongwei@126.com.
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. hxxiaozhenghua@163.com.
authors.forename: Zheng-hua
authors.initials: ZH
authors.lastname: Xiao
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. hxfangzhi@126.com.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Fang
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. hxqianhong@163.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Qian
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. hxzhongminghua@163.com.
authors.forename: Ming-hua
authors.initials: MH
authors.lastname: Zhong
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. hxguoyingqiang@126.com.
authors.forename: Ying-qiang
authors.initials: YQ
authors.lastname: Guo
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. zhangeryong0504@gmail.com.
authors.forename: Er-yong
authors.initials: EY
authors.lastname: Zhang
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. hxshiyingkang@gmail.com.
authors.forename: Ying-kang
authors.initials: YK
authors.lastname: Shi
authors.affiliation: Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxue Alley 37, Cheng du, 610041, Sichuan, People's Republic of China. mengwei11111@gmail.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Meng
mesh_terms: D000784:Aortic Dissection / Q000097:blood*; D017545:Aortic Aneurysm, Thoracic / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein