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

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Bossone, E; Pyeritz, RE; O'Gara, P; Harris, KM; Braverman, AC; Pape, L; Russo, MJ; Hughes, GC; Tsai, TT; Montgomery, DG; Nienaber, CA; Isselbacher, EM; Eagle, KA

Published Date

  • 2013

Published In

Volume / Issue

  • 126 / 10

Start / End Page

  • 909 - 915

International Standard Serial Number (ISSN)

  • 0002-9343

Digital Object Identifier (DOI)

  • 10.1016/j.amjmed.2013.04.020