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Epidemiology of thoracic aortic dissection.
Scott A LeMaire1, Ludivine Russell
1The Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA. slemaire@bcm.edu
Nature Reviews. Cardiology
|December 22, 2010
Summary
Thoracic aortic dissection (TAD) is a serious condition with increasing incidence, affecting older men most often. While aortic dilatation is a risk factor, genetic factors and other conditions also play a role.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Epidemiology
Background:
- Thoracic aortic dissection (TAD) is a life-threatening condition with an estimated incidence of 3-4 cases per 100,000 person-years.
- The true incidence may be higher due to diagnostic challenges, and TAD rates appear to be increasing.
- TAD predominantly affects men and older individuals, with aortic dilatation being a known risk factor.
Purpose of the Study:
- To review the epidemiology and risk factors associated with thoracic aortic dissection.
- To highlight the complexities in diagnosing and understanding the multifactorial nature of TAD.
Main Methods:
- Review of existing literature on thoracic aortic dissection incidence, demographics, and risk factors.
- Analysis of associations between TAD and various conditions including cardiovascular risk factors, genetic predispositions, and other diseases.
Main Results:
- Aortic dilatation is a risk factor, but most dissections occur with diameters <5.5 cm.
- While hypertension and smoking are associated with TAD, their direct causal role is not definitively established.
- Diabetes mellitus is notably uncommon in TAD patients. Genetic factors like bicuspid aortic valve, Marfan syndrome, and specific gene mutations are significant risk factors.
Conclusions:
- TAD is a complex condition influenced by a range of factors including genetics, aortic size, and potentially lifestyle, though direct causality for some factors remains unclear.
- Understanding these diverse risk factors is crucial for improving TAD diagnosis, prevention, and management strategies.
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