Glucocorticoids for Post-operative Patients With Acute Type A Aortic Dissection (The GLAD Trial)

Assessment of the Efficacy of Glucocorticoids in Improving Post-operative Organ Dysfunction in Patients With Acute Type A Aortic Dissection(GLAD): a Randomized Controlled Trial

This study is designed to evaluate the effects of glucocorticoid(GC) on improving post-operative organ dysfunction in patients with acute type A aortic dissection(aTAAD). Subjects with confirmed diagnosis of aTAAD undergoing surgical treatment will be enrolled and 1:1 randomly assigned to receive either glucocorticoids or normal treatment. All patients in the glucocorticoids group will be given methylprednisolone intravenously for 3 days after enrollment. The primary endpoint will be the amplitude of variation of Sequential Organ Failure Assessment score on post-operative day 4 compared to baseline.

Inclusion Criteria:

• Informed consent
• Age above 18 years old (including 18 years old), regardless of gender;
• Confirmed type A aortic dissection with computer tomography and received surgical intervention
• Life expectancy > 3 days after surgery

Exclusion Criteria:

• History of cardiac surgery within the past 3 months or possible iatrogenic aortic dissection
• Bacterial or fungal infection in the past 30 days
• Glucocorticoid or any other anti-inflammatory drug usage in the past 14 days
• Allergic to glucocorticoid
• Pregnant
• Implantation of ICD or permanent pacemaker
• Patients diagnosed with malignant tumor undergoing chemotherapy and immunotherapy.
• Patients with pre-operative severe liver dysfunction (CTP grade C)
• Patients with pre-operative renal insufficiency (patients receiving renal replacement therapy before surgery)