Acute aortic dissection in blacks: Insights from the international registry of acute aortic dissection

Eduardo Bossone, Reed E. Pyeritz, Patrick O'Gara, Kevin M. Harris, Alan C. Braverman, Linda Pape, Mark J. Russo, G. Chad Hughes, Thomas T. Tsai, Daniel G. Montgomery, Christoph A. Nienaber, Eric M. Isselbacher, Kim A. Eagle

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Background Few data exist on race-related differences in acute aortic dissection patients. Methods We evaluated black (n = 189, 14%) or white (n = 1165, 86%) patients (mean age 62.8 ± 15.3 years; 36.4% women) enrolled in 13 US centers participating in the International Registry of Acute Aortic Dissection. We excluded patients of other racial descent. Results Type B acute aortic dissection was more frequent in the black cohort (52.4% vs 39.3%, P =.001). Black patients were younger (mean age 54.6 ± 12.8 years vs 64.2 ± 15.2 years, P <.001) and more likely to have a history of cocaine abuse (12% vs 1.6%, P <.001), hypertension (89.7% vs 73.9%, P <.001), and diabetes (13.2% vs 6.4%, P =.001). Conversely, they were less likely to have bicuspid aortic valve (1.8% vs 5.8%, P =.029), iatrogenic dissection (0.5% vs 4.5%, P =.010), and prior aortic dissection repair (7.7% vs 12.8%, P =.047). Presenting features were similar except for more abdominal pain (44.6% vs 30.6%, P <.001) and left ventricular hypertrophy on echocardiogram (44.2% vs 20.1%, P <.001) in blacks. Management was similar. Hypotension/shock/tamponade was less common (7.6% vs 20.1%, P <.001), whereas acute kidney failure was more common (41.0% vs 21.7%, P <.001) in blacks. Mortality was similar in-hospital (14.3% vs 19.1%, P =.110, odds ratio 0.704, 95% confidence interval 0.457-1.085) and at 3 years postdischarge, as evaluated by Kaplan-Meier survival analysis (22.0% vs 14.3%, P =.224, SE = 0.062 and 0.018). Conclusions Our study shows differences in type, etiology, and presentation of blacks and whites with acute aortic dissection, yet similar mortality for these cohorts.

Original languageEnglish
Pages (from-to)909-915
Number of pages7
JournalAmerican Journal of Medicine
Volume126
Issue number10
DOIs
StatePublished - Oct 2013

Keywords

  • Aorta Epidemiology Mortality

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