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Stanford type B aortic dissection is more frequently associated with coronary artery atherosclerosis than type A

Naoki Hashiyama1, Motohiko Goda2, Keiji Uchida3

  • 1Department of Cardiovascular Surgery, Yokohama Minami-kyosai Hospital, Mutsuurahigashi 1-21-1, Kanazawa-ku, Yokohama, 236-0037, Japan.

Journal of Cardiothoracic Surgery
|June 28, 2018
PubMed

Insights

Stanford type B aortic dissection shows a higher prevalence of coronary artery atherosclerosis compared to type A. This study clarifies the association between dissection types and coronary artery disease severity.

Area of Science:

  • Cardiovascular Medicine
  • Thoracic Surgery
  • Diagnostic Imaging

Background:

  • The link between aortic dissection and coronary artery disease (CAD) requires further elucidation.
  • Understanding differences in CAD prevalence between aortic dissection types is crucial for patient management.

Purpose of the Study:

  • To investigate and compare the rates of coronary artery atherosclerosis in patients with Stanford type A versus type B acute aortic dissection.
  • To analyze coronary angiography findings in relation to aortic dissection classification.

Main Methods:

  • Retrospective analysis of 145 patients with acute aortic dissection undergoing coronary angiography (2000-2002).
  • Comparison of demographic data, cardiovascular risk factors, and coronary angiography results (stenosis number, Bogaty standards, extent index) between type A (n=71) and type B (n=74) dissection groups.
  • Statistical analysis to determine significant differences between the two groups.

Main Results:

  • Patients with type B aortic dissection had a significantly higher incidence of prior ischemic heart disease complications (P=0.04).
  • Type B dissection was associated with significantly more coronary stenoses (1.54±0.04 vs 0.38±0.1, P=0.005) and a higher coronary atherosclerosis severity index (1.49±0.09 vs 0.72±0.07, P<0.05) compared to type A.
  • Hypertension was the only other significant risk factor difference observed.

Conclusions:

  • Stanford type B acute aortic dissection is significantly more associated with coronary artery atherosclerosis than type A.
  • Findings suggest distinct pathophysiological links or risk factor profiles between aortic dissection subtypes and concurrent coronary artery disease.
Abstract

Keywords:
Acute aortic dissectionAthroscrelosisCoronary angiographyCoronary arteryStanford classification

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