Abstract: Objective To observe the activity of platelet protein kinase C (PKC) in patients with Stanford type A aortic dissection (TAAD) and to analyze its relationship with short-term prognosis after Bentall surgery. 
Methods In total, 216 TAAD patients who planned to undergo Bentall surgery in  the First Affiliated Hospital of Hebei North University from January 2020 to March 2023 were selected as the research subjects. All patients successfully underwent Bentall surgery, and their prognosis was evaluated based on the occurrence of adverse events within 30 d after surgery. They were divided into a poor prognosis group and a good prognosis group. The general data, platelet PKC activity and other laboratory indexes of the two groups were statistically analyzed, and the relationship between platelet PKC activity and short-term prognosis of TAAD patients after Bentall surgery was analyzed. 
Results Adverse events occurred in 56 of 216 patients within 30 d after surgery, and the incidence of adverse events was 25.93% (56/216). The proportion of pericardial effusion (71.43%) and lower limb ischemia (33.93%) in the poor prognosis group was higher than that in the good prognosis group (55.00%, 20.00%). The diastolic blood pressure (DBP) on admission ［(72.29±4.58) mmHg］,  platelet cytoplasmic PKC activity ［(192.86±9.66) pmol·min-1·mg-1］, and platelet count ［(181.24±17.53)×109/L］ were lower than those in the good prognosis group ［(74.83±4.26) mmHg, (201.51±9.21) pmol·min-1·mg-1, (190.79±20.51)×109/L］. The PKC activity of platelet membrane ［(319.23±19.66) pmol·min-1·mg-1］ and D-dimer (DD) value ［(527.87±14.14) μg/L］ were higher than those in the good prognosis group ［(297.52±15.48) pmol·min-1·mg-1, (519.58±13.37) μg/L］, with significant differences (P＜0.05). Point-biserial correlation analysis showed that platelet cytoplasmic PKC activity was negatively correlated with the risk of short-term adverse prognosis in TAAD patients after Bentall surgery (r=-0.379, P＜0.05), while PKC activity of platelet membrane was positively correlated with the risk of short-term adverse prognosis in TAAD patients after surgery (r=0.498, P＜0.05). Logistic regression analysis found that DBP, platelet cytoplasmic PKC activity, PKC activity of platelet membrane, and DD levels at admission were all influencing factors for the short-term prognosis of TAAD patients after Bentall surgery (OR=0.844, 0.867, 1.069, 1.069, P＜0.05). The analysis of the receiver operating curve (ROC) revealed that the areas under the curve of platelet cytoplasmic PKC activity and PKC activity of platelet membrane, both alone and in combination, for predicting short-term poor prognosis in TAAD patients after Bentall surgery were 0.741, 0.800, and 0.879, respectively,with certain predictive value, and the combined detection had higher predictive value. 
Conclusion Platelet PKC activity is related to the short-term prognosis of TAAD patients after Bentall surgery. The decrease in platelet cytoplasmic PKC activity and the increase in PKC activity of platelet membrane increase the risk of poor short-term prognosis in patients after surgery. Combined detection of the two can assist in early clinical screening of high-risk patients with poor prognosis. 

Key words: Aortic dissection, Stanford type A, Platelet protein kinase C, Prognosis, Correlation