期刊
AMERICAN JOURNAL OF MEDICINE
卷 126, 期 10, 页码 909-915出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjmed.2013.04.020
关键词
Aorta; Epidemiology; Mortality
资金
- W.L. Gore & Associates, Inc.
- Varbedian Aortic Research Fund
- Hewlett Foundation
- Mardigian Foundation
- UM Faculty Group Practice
- Terumo
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. (c) 2013 Elsevier Inc. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据