The use of angiotensin-converting enzyme inhibitors did not show association with mortality.Ĭopyright © 2012 Elsevier Inc. In contrast, use of calcium channel blockers was associated with improved survival selectively in those with type B (overall and in those treated medically). In conclusion, the present study showed that use of β blockers was associated with improved outcome in all patients and in type A patients (overall as well as in those managed surgically). Multivariate models also showed that the use of β blockers was associated with improved survival in those with type A undergoing surgery (odds ratio 0.47, 95% confidence interval 0.25 to 0.90, p = 0.02) and the use of calcium channel blockers was associated with improved survival in patients with type B medically treated patients (odds ratio 0.55, 95% confidence interval 0.35 to 0.88, p = 0.01). The analysis also showed that use of calcium channel blockers was associated with improved survival in patients with type B overall (p = 0.02) and in patients with type B receiving medical management (p = 0.03). The initial univariate analysis showed that use of β blockers was associated with improved survival in all patients (p = 0.03), in patients with type A overall (p = 0.02), and in patients with type A who received surgery (p = 0.006). A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with type B) with information on their medications at discharge and followed for ≤5 years were analyzed for the effects of the medications on mortality. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. Our data support the need for continued improvement in prevention, diagnosis, and management of acute aortic dissection.The effects of medications on the outcome of aortic dissection remain poorly understood. Despite recent advances, in-hospital mortality rates remain high. A high clinical index of suspicion is necessary. Surgery was performed in 20% of patients with type B dissection mortality in this group was 31.4%.Īcute aortic dissection presents with a wide range of manifestations, and classic findings are often absent. Mortality of patients with type B dissection treated medically was 10.7%. Mortality of patients with type A dissection managed surgically was 26% among those not receiving surgery (typically because of advanced age and comorbidity), mortality was 58%. Computed tomography was the initial imaging modality used in 61.1%. Classic physical findings such as aortic regurgitation and pulse deficit were noted in only 31.6% and 15.1% of patients, respectively, and initial chest radiograph and electrocardiogram were frequently not helpful (no abnormalities were noted in 12.4% and 31.3% of patients, respectively). We sought to determine sex-specific operative approaches and outcomes for TAAD in the current era. While sudden onset of severe sharp pain was the single most common presenting complaint, the clinical presentation was diverse. In 1996, the International Registry of Acute Aortic Dissection (IRAD) was established with the mission to better understand the presentation, diagnosis. Background: Worse outcomes have been reported for women with type A acute aortic dissection (TAAD). Presenting history, physical findings, management, and mortality, as assessed by history and physician review of hospital records. Patients present as acutely ill with a variety of. The International Registry of Acute Aortic Dissection, consisting of 12 international referral centers.Ī total of 464 patients (mean age, 63 years 65.3% male), 62.3% of whom had type A dissection. Acute aortic dissection is a life-threatening condition that remains challenging to diagnose and treat. Data were collected at presentation and by physician review of hospital records. To assess the presentation, management, and outcomes of acute aortic dissection.Ĭase series with patients enrolled between January 1996 and December 1998. Data are limited regarding the effect of recent imaging and therapeutic advances on patient care and outcomes in this setting. Methods and results: Accordingly, we analyzed 384 patients (65+/-13 years, males 71) with acute type B aortic dissection enrolled in the International Registry of Acute Aortic Dissection (IRAD). Acute aortic dissection is a life-threatening medical emergency associated with high rates of morbidity and mortality. Background: Clinical profiles and outcomes of patients with acute type B aortic dissection have not been evaluated in the current era.
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