Objectives We aimed to summarize the clinical presentations, therapeutic
approaches, and outcomes of type B intramural hematoma (IMHB) patients
with and without type 2 diabetes mellitus (DM). Methods Patients with
uncomplicated IMHBs were included between January 2016 and January 2018
and divided into two groups according to whether or not they had DM. Cox
proportional hazard analysis was utilized to investigate the risk
factors for aortic-related mortality. Kaplan-Meier survival analysis was
used to estimate cumulative mortality and aortic-related mortality.
Results A total of 149 patients were included and were divided into the
two groups (DM group [n=60] and non-DM group [n=89]). Patients
in the non-DM group underwent thoracic endovascular aortic repair
treatment more frequently (12% vs 2%, P=0.028) and had a higher
reintervention rate during the follow-up (9 in 81 patients, 11% vs 2%,
P=0.043). There were significant differences between the two groups
regarding the aorta-related mortality rate during the acute phase (9%
vs 0%, P=0.042) and the all-cause mortality rate (22% vs 7%,
P=0.011). Ulcer-like projection (ULP) development (during the acute
phase) (hazard ratio [HR], 1.07; 95% confidence interval [CI],
1.01-1.31, P=0.008), C-reactive protein (CRP) levels (HR, 1.92; 95% CI,
1.51-2.49, P<0.001) and MMP-9 levels (HR, 16.82; 95% CI,
7.52-28.71, P<0.001) were associated with an elevated risk for
aorta-related mortality. Conclusions IMHBs without DM are not benign and
have a considerably high aortic-related mortality rate. ULP development
(during the acute phase), CRP levels and maximum MMP-9 levels are
associated with an elevated risk for aorta-related mortality.
CHANGES IN BIOCHEMICAL FACTORS, INFLAMMATORY MEDIATORS AND PROTHROMBOTIC ACUTE PHASE PROTEINS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS ON 12 MONTHS OF DIETARY MODIFICATION