Clinical characteristics of acute aortic dissection
LI Yang
LIU Si-qi
DUAN Wei-xun
YU Shi-qiang
YI Ding-hua
Abstract：Objective To investigate the clinical characteristics of acute aortic dissection (AAD) in Chinese people for guiding diagnosis and treatment.Methods The clinical data were collected from 1812 patients with AAD diagnosed with imageological examinations [726 with Stanford type A AAD (group A) and 1086 with Stanford type B AAD (group B)] from 15 large heart centers from Jan. 1, 2008 to Dec. 31, 2011. The study content included demographic characteristics, complications, clinical manifestations, diagnosis, treatment, prognosis and follow-up. The difference in clinical characteristics was compared between two groups.Results The average age was (51.1± 10.9), and ratio of male to female was 3.44 to 1. The average age was higher in group B than that in group A [(53.3 ±10.1)vs. (47.5±11.2),P<0.001]. The percentage of male patients was higher in group A than that in group B (83.7%vs. 73.3%,P<0.001). In group B, 86.8% patients had hypertension, 22.0% had atherosclerosis and 49.5%had smoking history, and all of them were higher than those in group A (P<0.05). In group A, 32.5% had Marfan syndrome and 19.1% patients had bicuspid aortic valve, and all of them were significantly higher than those in group B (P<0.01). In group A, 89.4% patients had pain symptoms, among them 76.3% had anterior chest pain and 12.3%had migration pain. In group B, 73.8% patients had back pain and 14.2% had abdominal pain. The patients with CT scan for confirming diagnosis accounted for 76.3%. In group A, 75.3% patients had surgical therapies and mortality was 15.9%. In group B, 76.1% patients had intravascular intervention, 7.8% had postoperative endoleak and mortality was 0.6%. Cox hospitalization risk analysis showed that the hazard rate (HR) of complicating hypertension was 2.80, and HR of complicating Marfan syndrome was 1.76.Conclusion Compared with group B, the age of AAD attack is lower and male percentage is higher in group A. The most of patients in group B have complicating hypertension and atherosclerosis and smoking history, and most of those in group A have complicating Marfan syndrome and bicuspid aortic valve. Pain is main clinical manifestation and CT scan is the most common method for confirming diagnosis.
Keywords：Aortic dissectionClinical characteristics
Publication Date：2013-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 588-592,614 )