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Cocaine-related aortic dissection: lessons from the International Registry of Acute Aortic Dissection.

Publication ,  Journal Article
Dean, JH; Woznicki, EM; O'Gara, P; Montgomery, DG; Trimarchi, S; Myrmel, T; Pyeritz, RE; Harris, KM; Suzuki, T; Braverman, AC; Hughes, GC ...
Published in: Am J Med
September 2014

BACKGROUND: Acute aortic dissection associated with cocaine use is rare and has been reported predominantly as single cases or in small patient cohorts. METHODS: Our study analyzed 3584 patients enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2012. We divided the population on the basis of documented cocaine use (C+) versus non cocaine use (C-) and further stratified the cohorts into type A (33 C+/2332, 1.4%) and type B (30 C+/1252, 2.4%) dissection. RESULTS: C+ patients presented at a younger age and were more likely to be male and black. Type B dissections were more common among C+ patients than in C- patients. Cocaine-related acute aortic dissection was reported more often at US sites than at European sites (86.4%, 51/63 vs 13.6%, 8/63; P < .001). Tobacco use was more prevalent in the C+ cohort. No differences were seen in history of hypertension, known atherosclerosis, or time from symptom onset to presentation. Type B C+ patients were more likely to be hypertensive at presentation. C+ patients had significantly smaller ascending aortic diameters at presentation. Acute renal failure was more common in type A C+ patients; however, mortality was significantly lower in type A C+ patients. CONCLUSIONS: Cocaine use is implicated in 1.8% of patients with acute aortic dissection. The typical patient is relatively young and has the additional risk factors of hypertension and tobacco use. In-hospital mortality for those with cocaine-related type A dissection is lower than for those with non cocaine-related dissection, likely due to the younger age at presentation.

Duke Scholars

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

September 2014

Volume

127

Issue

9

Start / End Page

878 / 885

Location

United States

Related Subject Headings

  • Risk Factors
  • Registries
  • Middle Aged
  • Male
  • Illicit Drugs
  • Humans
  • General & Internal Medicine
  • Female
  • Cocaine-Related Disorders
  • Cocaine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dean, J. H., Woznicki, E. M., O’Gara, P., Montgomery, D. G., Trimarchi, S., Myrmel, T., … Bossone, E. (2014). Cocaine-related aortic dissection: lessons from the International Registry of Acute Aortic Dissection. Am J Med, 127(9), 878–885. https://doi.org/10.1016/j.amjmed.2014.05.005
Dean, Joshua H., Elise M. Woznicki, Patrick O’Gara, Daniel G. Montgomery, Santi Trimarchi, Truls Myrmel, Reed E. Pyeritz, et al. “Cocaine-related aortic dissection: lessons from the International Registry of Acute Aortic Dissection.Am J Med 127, no. 9 (September 2014): 878–85. https://doi.org/10.1016/j.amjmed.2014.05.005.
Dean JH, Woznicki EM, O’Gara P, Montgomery DG, Trimarchi S, Myrmel T, et al. Cocaine-related aortic dissection: lessons from the International Registry of Acute Aortic Dissection. Am J Med. 2014 Sep;127(9):878–85.
Dean, Joshua H., et al. “Cocaine-related aortic dissection: lessons from the International Registry of Acute Aortic Dissection.Am J Med, vol. 127, no. 9, Sept. 2014, pp. 878–85. Pubmed, doi:10.1016/j.amjmed.2014.05.005.
Dean JH, Woznicki EM, O’Gara P, Montgomery DG, Trimarchi S, Myrmel T, Pyeritz RE, Harris KM, Suzuki T, Braverman AC, Hughes GC, Kline-Rogers E, Nienaber CA, Isselbacher EM, Eagle KA, Bossone E. Cocaine-related aortic dissection: lessons from the International Registry of Acute Aortic Dissection. Am J Med. 2014 Sep;127(9):878–885.
Journal cover image

Published In

Am J Med

DOI

EISSN

1555-7162

Publication Date

September 2014

Volume

127

Issue

9

Start / End Page

878 / 885

Location

United States

Related Subject Headings

  • Risk Factors
  • Registries
  • Middle Aged
  • Male
  • Illicit Drugs
  • Humans
  • General & Internal Medicine
  • Female
  • Cocaine-Related Disorders
  • Cocaine