{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:29:54Z","timestamp":1784366994013,"version":"3.55.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Scientific Research Common Program of Beijing Municipal Commission of Education","award":["KM202110025014"],"award-info":[{"award-number":["KM202110025014"]}]},{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission","doi-asserted-by":"crossref","award":["Z211100002921010"],"award-info":[{"award-number":["Z211100002921010"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,22]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The incremental usefulness of circulating biomarkers from different pathological pathways for predicting mortality has not been evaluated in acute Type A aortic dissection (ATAAD) patients. We aim to develop a risk prediction model and investigate the impact of arch repair strategy on mortality based on distinct risk stratifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>A total of 3771 ATAAD patients who underwent aortic surgery retrospectively included were randomly divided into training and testing cohorts at a ratio of 7:3 for the development and validation of the risk model based on multiple circulating biomarkers and conventional clinical factors. Extreme gradient boosting was used to generate the risk models. Subgroup analyses were performed by risk stratifications (low vs. middle\u2013high risk) and arch repair strategies (proximal vs. extensive arch repair). Addition of multiple biomarkers to a model with conventional factors fitted an ABC risk model consisting of platelet\u2013leucocyte ratio, mean arterial pressure, albumin, age, creatinine, creatine kinase-MB, haemoglobin, lactate, left ventricular end-diastolic dimension, urea nitrogen, and aspartate aminotransferase, with adequate discrimination ability {area under the receiver operating characteristic curve (AUROC): 0.930 [95% confidence interval (CI) 0.906\u20130.954] and 0.954, 95% CI (0.930\u20130.977) in the derivation and validation cohort, respectively}. Compared with proximal arch repair, the extensive repair was associated with similar mortality risk among patients at low risk [odds ratio (OR) 1.838, 95% CI (0.559\u20136.038); P = 0.316], but associated with higher mortality risk among patients at middle\u2013high risk [OR 2.007, 95% CI (1.460\u20132.757); P &amp;lt; 0.0001].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In ATAAD patients, the simultaneous addition of circulating biomarkers of inflammatory, cardiac, hepatic, renal, and metabolic abnormalities substantially improved risk stratification and individualized arch repair strategy.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ehjdh\/ztac068","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T21:14:15Z","timestamp":1667337255000},"page":"587-599","source":"Crossref","is-referenced-by-count":10,"title":["Circulating biomarker-based risk stratifications individualize arch repair strategy of acute Type A aortic dissection via the XGBoosting algorithm"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8143-0912","authenticated-orcid":false,"given":"Hong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University , Nanjing 210029 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Chong","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University , Beijing 100029 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Beijing Chaoyang Hospital, Capital Medical University , Beijing 100043 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Yuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The First Affiliated Hospital of Guangzhou Medical University , Guangzhou 510120 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Laboratory, The First Affiliated Hospital of Shantou University Medical College , Shantou 515041 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University , Nanjing 210012 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Nong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University , Qingdao 266003 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji-Sheng","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Xiamen Cardiovascular Hospital, Xiamen University , Xiamen 361004 , P.R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Qi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Teda International Cardiovascular Hospital, Chinese Academy of Medical Sciences , Tianjin 300457 , P.R. 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