Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control

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Fang Liu1,2, Si-Chong Qian3, Shuai Jing4

  • 1Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Frontiers in Surgery
|September 27, 2021
PubMed

Insights

Patients with acute myocardial infarction and aortic dissection face high mortality rates, especially women. Surgical management appears to reduce mortality in these complex cases.

Area of Science:

  • Cardiovascular Medicine
  • Thoracic Surgery

Background:

  • Acute myocardial infarction (AMI) and aortic dissection (AD) management present conflicting strategies.
  • Limited data exists on the combined incidence, risk factors, and outcomes of AMI and AD.
  • No prior studies have investigated the long-term prognosis of AMI in patients with AD.

Purpose of the Study:

  • To investigate the long-term outcomes of patients experiencing both AMI and AD.
  • To identify key risk factors and prognostic indicators for this patient cohort.
  • To propose a diagnostic paradigm for managing concurrent AMI and AD.

Main Methods:

  • A consecutive series of patients with AD and AMI from 2010-2017 were analyzed.
  • Data collected included baseline characteristics, risk factors, treatments, echocardiographic, and laboratory parameters.
  • Follow-up extended from initial hospitalization until March 2018 for major adverse events or death.

Main Results:

  • The incidence of concomitant AD and AMI was 0.13% and 7.49% respectively.
  • The average age was 53.3 years, with 84.6% males; hypertension and smoking were prevalent risk factors.
  • In-hospital mortality was 10.3%, with 5-year fatality rates at 35.9%, significantly higher in females (66.7%) versus males (30.3%).

Conclusions:

  • Patients with concurrent AMI and AD have a poor 5-year survival rate.
  • Surgical management is associated with reduced mortality in this high-risk group.
  • Aggressive control of hypertension and smoking cessation may decrease the incidence of combined AMI and AD.

Keywords:
acute myocardial infarctionaorta dissectionincidencelong-term outcomesrisk factors

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