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Gender Differences in Acute Type A Aortic Dissection: A Comprehensive Review and Meta-Analysis
He Jiao1, Xiankun Liu2, Yiming Bai2
1Medical School, Tianjin University, Tianjin, China; Department of Cardiac Surgery, Chest Hospital, Tianjin University, Tianjin, China.
The American Journal of Cardiology
|December 26, 2024
Summary
Women with acute type A aortic dissection face higher mortality risks and poorer long-term survival than men, despite lower risks of kidney injury and reoperation. Tailored strategies are needed for female patients.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Aortic Disease Research
Background:
- Acute type A aortic dissection (aTAAD) is a life-threatening condition with significant morbidity and mortality.
- Understanding gender-based differences in aTAAD is crucial for optimizing patient care and outcomes.
Purpose of the Study:
- To conduct a meta-analysis of cohort studies evaluating gender-specific disparities in the clinical presentation, management, and outcomes of acute type A aortic dissection.
- To compare perioperative and long-term survival rates between men and women diagnosed with aTAAD.
Main Methods:
- Systematic literature search of PubMed, Embase, and Cochrane Library (2000-2023).
- Meta-analysis of 21 cohort studies including 6,728 women and 12,839 men.
- Assessment of study effects using risk ratios (RR) and Kaplan-Meier survival analysis.
Main Results:
- Women exhibited lower risks of postoperative acute kidney injury (RR 0.85) and reoperation (RR 0.89) compared to men.
- Women experienced higher perioperative mortality (RR 1.11) and poorer overall survival, with 10-year survival rates of 60.0% vs. 66.5% for men.
- Significant gender-based differences were observed in clinical presentation, management, and outcomes.
Conclusions:
- Acute type A aortic dissection presents distinct gender-based differences, with women facing increased perioperative and long-term mortality.
- Despite lower risks for certain complications, women with aTAAD require targeted management and prevention strategies.
- Further research into sex-specific factors influencing aTAAD is warranted to improve patient outcomes.
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