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Sex-Related Differences in Clinical Features and In-Hospital Outcomes of Type B Acute Aortic Dissection: A Registry
Toshiyuki Takahashi1,2, Hideaki Yoshino1, Koichi Akutsu1
1Tokyo CCU Network Scientific Committee Tokyo Japan.
Journal of the American Heart Association
|May 2, 2022
Summary
Older women with type B acute aortic dissection presented with more intramural hematoma and higher mortality. However, female sex was not independently associated with in-hospital mortality in this study.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Research
Background:
- Sex-based outcome differences in type A acute aortic dissection are known.
- Limited data exists on sex disparities in type B acute aortic dissection (TBAD), including classic dissection and intramural hematoma.
- This study investigates clinical features and in-hospital outcomes stratified by sex in TBAD patients.
Purpose of the Study:
- To elucidate sex-related differences in clinical presentation and in-hospital outcomes of type B acute aortic dissection.
- To identify factors associated with in-hospital mortality in TBAD patients, considering sex as a variable.
Main Methods:
- Analysis of 2372 patients with TBAD from the Tokyo Acute Aortic Super-Network Registry.
- Comparison of demographic, clinical, and outcome data between male and female patients.
- Multivariable logistic regression analysis to determine predictors of in-hospital mortality.
Main Results:
- Women were older, presented less frequently with end-organ malperfusion, and had higher in-hospital mortality compared to men.
- Women had a higher proportion of intramural hematoma and were more often medically managed.
- Independent predictors of mortality included older age, hyperlipidemia, painlessness, shock, non-intramural hematoma, aortic rupture, and end-organ malperfusion.
Conclusions:
- Women with TBAD are older and exhibit distinct clinical characteristics, including a higher prevalence of intramural hematoma and lower rates of malperfusion.
- Despite higher crude in-hospital mortality, female sex was not an independent predictor of mortality after adjusting for other clinical factors.
- These findings highlight important sex-based differences in TBAD presentation and outcomes, emphasizing the need for tailored clinical assessment.
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