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Background <p>Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency with substantial early mortality. Whether diabetes mellitus (DM) independently influences short-term mortality in ATAAD remains uncertain. We conducted a meta-analysis to synthesize the available data.</p> Methods <p>PubMed, Embase, and Web of Science were searched from inception to June 22, 2025, for longitudinal studies reporting short-term mortality (in-hospital or 30-day) in ATAAD patients with and without DM. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model accounting for the influence of heterogeneity. Subgroup, sensitivity, and meta-regression analyses explored heterogeneity. The study quality was assessed with the Newcastle–Ottawa Scale (NOS).</p> Results <p>Twenty-one retrospective cohort studies involving 19,291 patients were included. DM was associated with a modestly increased short-term mortality risk (OR = 1.48; 95% CI 1.14 to 1.91; <i>p</i> = 0.003; <i>I</i><sup>2</sup> = 44%). The results were consistent in sensitivity analyses restricted to surgical patients (OR = 1.52; 95% CI 1.18 to 1.96; <i>p</i> = 0.001). Subgroup analyses showed no significant differences by region, follow-up duration, analytic model, or NOS score (all <i>p</i> for subgroup differences &gt; 0.05). Meta-regression analysis showed that sample size was negatively correlated with the association (coefficient = − 0.000074, <i>p</i> = 0.02), which fully explained the source of heterogeneity (adjusted <i>R</i><sup>2</sup> = 100%).</p> Conclusions <p>This meta-analysis of retrospective studies suggests that DM may be associated with higher short-term mortality in ATAAD. Given the observational nature of the evidence, further prospective studies are needed to clarify this relationship.</p>

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Influence of diabetes on short-term mortality of patients with acute type A aortic dissection: a meta-analysis

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  • 发表日期：

    2025年11月26日

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  • Zhiheng Liu,
  • Ning Wu,
  • Fan Wu,
  • Tao Liu,
  • Kai Ren

摘要

Background

Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency with substantial early mortality. Whether diabetes mellitus (DM) independently influences short-term mortality in ATAAD remains uncertain. We conducted a meta-analysis to synthesize the available data.

Methods

PubMed, Embase, and Web of Science were searched from inception to June 22, 2025, for longitudinal studies reporting short-term mortality (in-hospital or 30-day) in ATAAD patients with and without DM. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model accounting for the influence of heterogeneity. Subgroup, sensitivity, and meta-regression analyses explored heterogeneity. The study quality was assessed with the Newcastle–Ottawa Scale (NOS).

Results

Twenty-one retrospective cohort studies involving 19,291 patients were included. DM was associated with a modestly increased short-term mortality risk (OR = 1.48; 95% CI 1.14 to 1.91; p = 0.003; I2 = 44%). The results were consistent in sensitivity analyses restricted to surgical patients (OR = 1.52; 95% CI 1.18 to 1.96; p = 0.001). Subgroup analyses showed no significant differences by region, follow-up duration, analytic model, or NOS score (all p for subgroup differences > 0.05). Meta-regression analysis showed that sample size was negatively correlated with the association (coefficient = − 0.000074, p = 0.02), which fully explained the source of heterogeneity (adjusted R2 = 100%).

Conclusions

This meta-analysis of retrospective studies suggests that DM may be associated with higher short-term mortality in ATAAD. Given the observational nature of the evidence, further prospective studies are needed to clarify this relationship.