Comment on “Protective effect of dexmedetomidine on perioperative myocardial injury in patients with Stanford type-A aortic dissection”

Dear Editor,

We have carefully read the research literature of Wang Dalong and others on “dexamethasone can reduce the inflammatory response and thus reduce the myocardial injury in Stanford type A aortic dissection patients”¹. This study compared the heart rate, mean arterial pressure at different time points, serum creatine kinase MB, cardiac troponin I, C-reactive protein, and tumor necrosis factor-α between the dexamethasone group and the control group, and proposed that “dexamethasone treatment can reduce perioperative myocardial injury in patients with Stanford type A aortic dissection and its mechanism may be related to resistance to inflammatory response and oxidative stress.” As a clinician in the emergency department, this study has a high reference value for our clinical work. However, we still have several problems to discuss with the channel.

First of all, we know that Stanford’s classification of aortic dissection is a rough classification. In recent years, many scholars have proposed a variety of subtype schemes for Stanford type A aortic dissection based on their clinical experience, anatomical location, prognosis, and other factors^2,3. We hope that this study will further show the general demographic characteristics of the selected cases, as well as the specific anatomical location of Stanford type A aortic dissection and other individual case characteristics, so as to further judge the clinical application scope and value of this study.

Second, the prognostic indicators of Stanford type A aortic dissection patients, such as survival time follow-up, incidence of complications, and postoperative physical recovery, are the key results that directly reflect the effect of dexamethasone in the perioperative period. We hope that the follow-up research of this study can fully show.

• Funding: none.

REFERENCES

• ¹
  Wang D, Lin Q, Du M, Zheng G, Xu W, Zhang H, et al. Protective effect of dexmedetomidine on perioperative myocardial injury in patients with Stanford type-A aortic dissection. Rev Assoc Med Bras (1992). 2020;66(12):1638-44. https://doi.org/10.1590/1806-9282.66.12.1638
  » https://doi.org/10.1590/1806-9282.66.12.1638
• ²
  Zhu Y, Lingala B, Baiocchi M, Tao JJ, Toro Arana V, Khoo JW, et al. Type A aortic dissection-experience over 5 decades: JACC historical breakthroughs in perspective. J Am Coll Cardiol. 2020;76(14):1703-13. https://doi.org/10.1016/j.jacc.2020.07.061
  » https://doi.org/10.1016/j.jacc.2020.07.061
• ³
  Kuroyanagi S, Higashiue S, Komooka M, Furuya O, Hiramatsu N, Kojima S, et al. Treatment Strategy for Stanford Type A Acute Aortic Dissection. Kyobu Geka. 2020;73(8):563-71. PMID: 32879281

Publication Dates

• Publication in this collection
  22 Oct 2021
• Date of issue
  July 2021

History

• Received
  04 May 2021
• Accepted
  23 May 2021