Correlation between gender and long-term prognosis of patients with type B acute aortic dissection after endovascular therapy_West China Medical Journal

Authors：

LI Ling , LI Dongze ,  CAO Yu

Emergency Department, West China Hospital, Sichuan University, Chendu, Sichuan 610041, P. R. China;

Corresponding author：

CAO Yu, Email: yuyuer@126.com

Keywords：

Gender; Type B aortic dissection; Endovascular therapy; Complications; Mortality

DOI：

10.7507/1002-0179.201705076

Video：

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Objective To explore the correlation between gender and long-term prognosis of patients with type-B acute aortic dissection (AAD) after endovascular therapy (EVT). Methods From January to December 2012, all patients with type-B AAD undergoing EVT were enrolled by retrospective and observational study. They were divided into male and female groups. Kaplan-Meier analysis was used to analyze the correlation between gender and the cumulative survival rate. Results A total of 131 tyep-B AAD patients who had undergone EVT were selected, including 97 males (74.0%), and 34 females (26.0%). The medium follow-up duration was 2.1 years. Smoking history, cholesterol, white blood cell count, hemoglobin, creatinine and uric acid of the patients in males were higher than those in females (P<0.05); while the difference in other indexes were not significant (P>0.05). The inhospital mortality of male patients was 10 (10.3%), and was 3 (8.8%) in female patients; there was no significant difference between the two groups (P=0.803). Kaplan-Meier analysis showed that there was no significant difference in cumulative survival rate between the two groups (84.5% vs. 82.4%; Logrank test χ²=0.023, P=0.880). Conclusion No correlation between gender and long-term prognosis in patients with type-B AAD after EVT is found.

Citation： LI Ling, LI Dongze, CAO Yu. Correlation between gender and long-term prognosis of patients with type B acute aortic dissection after endovascular therapy. West China Medical Journal, 2017, 32(6): 808-811. doi: 10.7507/1002-0179.201705076 Copy

1.	Blomkalns AL, Chen AY, Hochman JS, et al. Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the American College of Cardiology/American Heart Association guidelines) national quality improvement initiative. J Am Coll Cardiol, 2007, 45(6): 832-837.
2.	Pleumeekers HJ, Hoes AW, van der Does E, et al. Aneurysms of the abdominal aorta in older adults. The rotterdam study. Am J Epidemiol, 1996, 142(12): 1291-1299.
3.	Scott RA, Bridgewater SG, Ashton HA. Randomized clinical trial of screening for abdominal aortic aneurysm in women. Br J Surg, 2002, 89(3): 283-285.
4.	Daugherty A, Cassis LA. Mouse models of abdominal aortic aneurysms. Arterioscler Thromb Vasc Biol, 2004, 24(3): 429-434.
5.	Tolenaar JL, Van Keulen JW, Jonker FH, et al. Morphologic predictors of aortic dilatation in type B aortic dissection. J Vasc Surg, 2013, 58(5): 1220-1225.
6.	Jonker FH, Trimarchi S, Rampoldi V, et al. Aortic expansion after acute type B aortic dissetion. Ann Thorac Surg, 2012, 94(4): 1223-1229.
7.	Sueyoshi E, Sakamoto I, Hayashi K, et al. Growth rate of aortic diameter in patient with type B aortic dissection during the chronic phase. Circulation, 2004, 110(11): 256-261.
8.	Hagan PG, Nienaber CA, Isselbacher EM, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA, 2000, 283(7): 897-903.
9.	Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies. Circulation, 2003, 108(5): 628-635.
10.	Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol, 1984, 53(6): 849-855.
11.	Januzzi JL, Isselbacher EM, Fattori R, et al. Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD). J Am Coll Cardiol, 2004, 43(4): 665-669.
12.	Fattori R, Cao P, De Rango P, et al. Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol, 2013, 61(16): 1661-1678.
13.	Henriques TA, Huang J, D’Souza SS, et al. Orchidectomy, but not ovariectomy, regulates angiotensinⅡ-induced vascular diseases in apolipoprotein E-deficient mice. Endocrinology, 2004, 145(8): 3866-3872.
14.	Liao X, Thrasher JB, Pelling J, et al. Androgen stimulates matrix metalloproteinase-2 expression in human prostate cancer. Endocrinology, 2003, 144(5): 1656-1663.
15.	Ailawadi G, Eliason JL, Roelofs KJ, et al. Gender differences in experimental aortic aneurysm formation. Arterioscler Thromb Vasc Biol, 2004, 24(11): 2116-2122.
16.	李松涛, 李然, 李琳, 等. 雌激素缺乏对大鼠肝脏胆固醇代谢的影响及机制. 实用医学杂志, 2015, 31(21): 3489-3492.
17.	Rao GN, Corson MA, Berk BC. Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem, 1991, 266(13): 8604-8608.
18.	谢譞明. 白细胞计数与社区老年人代谢综合征相关分析. 上海: 复旦大学, 2013.

1. Blomkalns AL, Chen AY, Hochman JS, et al. Gender disparities in the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: large-scale observations from the CRUSADE (can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the American College of Cardiology/American Heart Association guidelines) national quality improvement initiative. J Am Coll Cardiol, 2007, 45(6): 832-837.
2. Pleumeekers HJ, Hoes AW, van der Does E, et al. Aneurysms of the abdominal aorta in older adults. The rotterdam study. Am J Epidemiol, 1996, 142(12): 1291-1299.
3. Scott RA, Bridgewater SG, Ashton HA. Randomized clinical trial of screening for abdominal aortic aneurysm in women. Br J Surg, 2002, 89(3): 283-285.
4. Daugherty A, Cassis LA. Mouse models of abdominal aortic aneurysms. Arterioscler Thromb Vasc Biol, 2004, 24(3): 429-434.
5. Tolenaar JL, Van Keulen JW, Jonker FH, et al. Morphologic predictors of aortic dilatation in type B aortic dissection. J Vasc Surg, 2013, 58(5): 1220-1225.
6. Jonker FH, Trimarchi S, Rampoldi V, et al. Aortic expansion after acute type B aortic dissetion. Ann Thorac Surg, 2012, 94(4): 1223-1229.
7. Sueyoshi E, Sakamoto I, Hayashi K, et al. Growth rate of aortic diameter in patient with type B aortic dissection during the chronic phase. Circulation, 2004, 110(11): 256-261.
8. Hagan PG, Nienaber CA, Isselbacher EM, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA, 2000, 283(7): 897-903.
9. Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies. Circulation, 2003, 108(5): 628-635.
10. Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol, 1984, 53(6): 849-855.
11. Januzzi JL, Isselbacher EM, Fattori R, et al. Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD). J Am Coll Cardiol, 2004, 43(4): 665-669.
12. Fattori R, Cao P, De Rango P, et al. Interdisciplinary expert consensus document on management of type B aortic dissection. J Am Coll Cardiol, 2013, 61(16): 1661-1678.
13. Henriques TA, Huang J, D’Souza SS, et al. Orchidectomy, but not ovariectomy, regulates angiotensinⅡ-induced vascular diseases in apolipoprotein E-deficient mice. Endocrinology, 2004, 145(8): 3866-3872.
14. Liao X, Thrasher JB, Pelling J, et al. Androgen stimulates matrix metalloproteinase-2 expression in human prostate cancer. Endocrinology, 2003, 144(5): 1656-1663.
15. Ailawadi G, Eliason JL, Roelofs KJ, et al. Gender differences in experimental aortic aneurysm formation. Arterioscler Thromb Vasc Biol, 2004, 24(11): 2116-2122.
16. 李松涛, 李然, 李琳, 等. 雌激素缺乏对大鼠肝脏胆固醇代谢的影响及机制. 实用医学杂志, 2015, 31(21): 3489-3492.
17. Rao GN, Corson MA, Berk BC. Uric acid stimulates vascular smooth muscle cell proliferation by increasing platelet-derived growth factor A-chain expression. J Biol Chem, 1991, 266(13): 8604-8608.
18. 谢譞明. 白细胞计数与社区老年人代谢综合征相关分析. 上海: 复旦大学, 2013.

West China Medical Journal

Correlation between gender and long-term prognosis of patients with type B acute aortic dissection after endovascular therapy

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