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Gender Differences in Acute Aortic Dissection

Eduardo Bossone1, Andreina Carbone2, Kim A Eagle3

  • 1Cardiac Rehabilitation Unit, Cardarelli Hospital, 9 Antonio Cardarelli Street, 80131 Naples, Italy.

Journal of Personalized Medicine
|July 27, 2022
PubMed

Insights

Acute aortic dissection (AAD) presents differently in women, who are older, have more comorbidities, and experience higher in-hospital mortality for Type A AAD. Gender-specific strategies are needed for this cardiovascular disease.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Epidemiology

Background:

  • Cardiovascular disease (CVD) is a leading cause of global mortality and morbidity.
  • Significant epidemiological and management differences exist between male and female CVD patients.
  • Acute aortic dissection (AAD) exhibits distinct characteristics in women compared to men.

Purpose of the Study:

  • To investigate gender-based differences in the presentation, management, and outcomes of acute aortic dissection (AAD).
  • To identify specific clinical features and comorbidities associated with AAD in female patients.
  • To highlight the need for gender-specific strategies in AAD prevention, diagnosis, and treatment.

Main Methods:

  • Retrospective analysis of patient data for acute aortic dissection (AAD).
  • Comparison of demographic, clinical, and management characteristics between male and female patients.
  • Stratification of outcomes based on AAD type (Type A and Type B) and gender.

Main Results:

  • Women with AAD are older at diagnosis, present less frequently with abrupt pain, and have higher rates of hypertension and COPD.
  • In Type A AAD, women show higher rates of pleural effusion and coronary compromise but fewer neurological/malperfusion symptoms, leading to less surgery and higher in-hospital mortality.
  • No significant gender difference in in-hospital mortality was observed for Type B AAD.

Conclusions:

  • Acute aortic dissection (AAD) exhibits significant gender-specific variations in presentation, comorbidities, and outcomes, particularly for Type A.
  • Women with Type A AAD face poorer in-hospital outcomes, underscoring a critical need for tailored approaches.
  • Further research is essential to develop gender-specific preventive, diagnostic, and therapeutic strategies for AAD.

Keywords:
acute aortic dissectiongenderpregnancysextype A aortic dissectiontype B aortic dissection

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