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Is Compliance With Guideline Recommended Follow-Up After Aortic Dissection Associated With Survival?

Amit Sharma1, Jesse M Manunga1, Larissa Stanberry1

  • 1Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minnesota.

The Annals of Thoracic Surgery
|April 20, 2021
PubMed

Insights

Adherence to aortic dissection follow-up guidelines is crucial. Patients with low compliance face double the lifetime risk of death after aortic dissection compared to those with high compliance.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Clinical Outcomes Research

Background:

  • Patients with acute aortic dissection (AD) require lifelong monitoring per ACC/AHA guidelines.
  • Long-term outcomes associated with adherence to these follow-up recommendations are not well-established.

Purpose of the Study:

  • To evaluate the impact of follow-up compliance on long-term mortality in patients surviving acute aortic dissection.
  • To identify factors associated with adherence to recommended follow-up care.

Main Methods:

  • Retrospective cohort study of 172 patients who survived hospital discharge for AD.
  • Analysis of compliance with initial (3-month) and long-term follow-up appointments.
  • Primary endpoint was all-cause mortality.

Main Results:

  • 71% attended the first follow-up; 52% attended >2/3 of recommended appointments.
  • Noncompliance with long-term follow-up increased the risk of death by 50% (HR 1.6).
  • Low compliance (<1/3 appointments) doubled the lifetime risk of death (HR 2.2) compared to high compliance (>2/3 appointments).

Conclusions:

  • Nearly one-third of AD patients miss their first follow-up, predicting poor adherence.
  • Low follow-up compliance significantly increases long-term mortality risk in acute aortic dissection survivors.
Abstract

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