Outcomes of Asian and Caucasian patients with type A aortic intramural haematoma: a multicentre registry analysis

doi:10.1136/heartjnl-2026-328023

Aortic & peripheral vascular diseaseCohort study

Outcomes of Asian and Caucasian patients with type A aortic intramural haematoma: a multicentre registry analysis

HeartPublished 9 Sep 2026

multicentre registry analysis
individual patient data
eight institutions (five Asian and three Western)

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Authors' conclusion

In patients with type A IMH, race was not associated with long-term mortality. The initial clinical presentation and imaging characteristics were the primary determinants of clinical outcomes.

Study context

Population: Patients with type A aortic intramural haematoma (IMH)patients with type A IMH
Participants: 485 patients

Exposure: Asian vs Caucasian patients with type A IMH
Caucasiann = 147reference
Outcome: Overall mortality (long-term mortality)
Follow-up: Median 6.9 years

Main finding

As reported in the abstract

Hazard ratio

1.38

95% CI 0.73–2.60

P = 0.32

Asian vs Caucasian

HR 1.38 (95% CI 0.73–2.60); P = 0.32

Deaths during follow-up: 121

Observational data: associations, not effects.

Further findings

Outcome	Lower risk vs caucasian ←→ Higher risk vs caucasian	HR (95% CI)	P value
Independent predictors of long-term mortality — Age vs Caucasian		1.42 (1.17–1.72)	P < 0.001
Independent predictors of long-term mortality — Ascending aorta diameter vs Caucasian		1.05 (1.02–1.09)	P < 0.001
Independent predictors of long-term mortality — Medical treatment due to prohibitive surgical risk vs Caucasian		3.00 (1.45–6.22)	P < 0.003
	0.10.31310Hazard ratio (log scale)

Baseline characteristics (Caucasian vs Asian)

Age Asian 66.8 years · Caucasian 69.3 years

Bicuspid aortic valve

Asian0.6%

Caucasian4.1%

Visceral ischaemia

Asian1.5%

Caucasian6.1%

Limb ischaemia

Asian0.3%

Caucasian3.4%

Shock

Asian6.8%

Caucasian21.1%

Haematoma thickness Asian 10.5±5.2 mm · Caucasian 12.5±4.8 mm

Ascending aorta Asian 47.7±7.2 mm · Caucasian 51.5±7.8 mm

Initial medical treatment

Outcome	Asian	Caucasian	Estimate	P value
Treatment received	85.5%	45.6%

patients

Treatment received — Urgent surgery: 129 (26.6%)
Treatment received — Medical treatment: 356 (73.4%)

Original publication

Outcomes of Asian and Caucasian patients with type A aortic intramural haematoma: a multicentre registry analysis. Heart. Published 9 September 2026. doi:10.1136/heartjnl-2026-328023

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Summarised from the published abstract; every number is checked against it