Aortic & peripheral vascular diseaseCohort study
Prognostic Implications of Initial Focal Contrast Enhancement in Acute Type B Intramural Hematoma
- Retrospective cohort study
- multicentre
Authors' conclusion
Patients with FCE accompanying IMH were more likely to progress, especially in those initial FID localized at the proximal descending aorta.
Study context
- Population
- Patients with acute type B intramural hematoma (IMH)
- Participants
- 574 patients
- Exposure
- IMH with initial focal contrast enhancement (FCE) vs without FCE
- FCEn = 207
- Outcome
- Adverse aortic events (AAEs)
Main finding
Independent risk factors of AAEs
Hazard ratio
1.51
95% CI 1.12–2.02
P = 0.006
FCE vs No FCE
HR 1.51 (95% CI 1.12–2.02); P = 0.006
As reported in the abstract
- More adverse aortic events (AAEs) with FCE
- P < 0.001
- Fewer freedom from intervention with FCE
- P = 0.002
- Pleural effusion as independent risk factor of AAEs (HR 1.79; 95% CI 1.25-2.55)
- P = 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Values | HR (95% CI) | P value | |
|---|---|---|---|---|
| AAEs with FID at proximal descending aorta | 2.95 (1.65–5.29) | P < 0.001 | ||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| FCE subtypes | FID 63.8% · IBP 36.2% |
- FCE subtypes — IMH with initial focal intimal disruption (FID) more likely to progress than with initial intramural blood pool (IBP) (subgroup)
- P < 0.001
Baseline differences with FCE
- More hypertension
- P = 0.001
- More pleural effusion
- P = 0.006
- Fewer aortic segments involved
- P < 0.001
Original publication
Prognostic Implications of Initial Focal Contrast Enhancement in Acute Type B Intramural Hematoma. J Am Coll Cardiol. Published 30 January 2024. doi:10.1016/j.jacc.2023.10.046
Summarised from the published abstract; every number is checked against it