Sex-Based Aortic Dissection Outcomes From the International Registry of Acute Aortic Dissection

Huckaby, Lauren V.; Sultan, Ibrahim; Trimarchi, Santi; Leshnower, Bradley G.; Chen, Edward P.; Brinster, Derek R.; Myrmel, Truls; Estrera, Anthony L.; Montgomery, Daniel; Korach, Amit; Eckstein, Hans‐Henning; Coselli, Joseph S.; Ota, Takeyoshi; Kaiser, Clayton A.; Eagle, Kim A.; Patel, Himanshu J.; Gleason, Thomas G.

doi:10.1016/j.athoracsur.2021.03.100

Cited by 60 publications

(105 citation statements)

References 24 publications

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“…A more recent analysis of an IRAD-Interventional Cohort (IVC) [ 32 ], consisting of more than 2823 type A AAD patients treated with endovascular, surgical, or hybrid procedures has partly confirmed the previous IRAD data about gender differences ( Table 1 ). Of particular interest was the fact that, overall, in-hospital mortality was 16.7% in women (n = 162) and 13.8% in men (n = 256, p = 0.039).…”

Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 74%

“…Of particular interest was the fact that, overall, in-hospital mortality was 16.7% in women (n = 162) and 13.8% in men (n = 256, p = 0.039). The frequency of postoperative complications was similar between genders, except for acute kidney injury, which was lower in women (17.7% vs. 21.2%, p = 0.029) [ 32 ].…”

Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 99%

“…However, five-years survival (82.6% in women vs. 85.9% in men) and reintervention (87.8% in women vs. 87.6% in men) were similar between genders [ 32 ]. Furthermore, the authors found that operative approaches were different between genders.…”

Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 99%

“…Furthermore, the authors found that operative approaches were different between genders. As a note, complete arch replacement (OR = 7.3; 95% CI 2.07–25; p = 0.002) along with age (OR = 1.04; 95% CI 1.03–1.05; p < 0.001), renal failure (OR = 2.68; 95% CI 1.91–3.74; p < 0.001), coma (OR = 13.38; 95% CI 7.87–22.73; p < 0.001), limb ischemia (OR = 1.87; 95% CI 1.23–2.86; p = 0.003), and cardiopulmonary bypass time (OR = 1.01; 95% CI 1.01–1.01; p < 0.001) were independent predictors of in-hospital mortality in both genders [ 32 ].…”

Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 99%

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Gender Differences in Acute Aortic Dissection

Bossone

Carbone

Eagle

2022

JPM

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Cardiovascular disease (CVD) represents the most important cause of mortality and morbidity worldwide. There is heterogeneity in the epidemiology and management of CVD between male and female patients. In the specific case of acute aortic dissection (AAD), women, at the time of diagnosis, are older than men and complain less frequently of an abrupt onset of pain with delayed presentation to the emergency department. Furthermore, a history of hypertension and chronic obstructive pulmonary disease is more common among women. In type A AAD, women more often experience pleural effusion and coronary artery compromise, but experience less neurological and malperfusion symptoms. They undergo less frequent surgical treatment and have higher overall in-hospital mortality. Conversely, in type B AAD no significant differences were shown for in-hospital mortality between the two genders. However, it should be highlighted that further studies are needed in order to develop AAD gender specific preventive, diagnostic and therapeutic strategies.

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Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 74%

Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 99%

Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 99%

Section: Insights Into Gender Related Aad From the Iradmentioning

confidence: 99%

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Gender Differences in Acute Aortic Dissection

Bossone

Carbone

Eagle

2022

JPM

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“…Previous studies indicated that the risk of dissection for ATAAs was gender related [ 1 , 11–13 ]. Although the incidence of AD was higher in males, females tended to be older when dissection occurred [ 14 ]. This may be related to worse biomechanical properties of elderly females’ aortas.…”

Section: Introductionmentioning

confidence: 99%

Gender differences in the dissection properties of ascending thoracic aortic aneurysms

Tong

Abudupataer

et al. 2022

Interactive CardioVascular and Thoracic Surgery

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OBJECTIVES Presentation, management and outcomes in the aortic dissection (AD) of ascending thoracic aortic aneurysm (ATAA) differ in gender and age. The purpose of this study is to investigate the dissection properties of male and female ATAAs. METHODS Peeling tests were performed to quantitatively determine the delamination strength and dissection energy of 41 fresh ATAA samples (22 males and 19 females) in relatively young (≤65 years) and elderly (>65 years) patients. The delamination strength of the ATAAs was further correlated with patient ages for males and females. The histological investigation was employed to characterize the dissected morphology. RESULTS For elderly patients, circumferential and longitudinal delamination strengths of the female ATAAs were statistically significantly lower than those of the males (circumferential: 31 ± 6 vs 42 ± 6 mN/mm, P < 0.01; longitudinal: 35 ± 7 vs 49 ± 10 mN/mm, P = 0.02). No significant differences were found in the delamination strength between males and females for relatively young patients. The circumferential and longitudinal delamination strengths were significantly decreased and strongly correlated with patient ages for females. However, these correlations were not present in males. Dissection routes propagated in the aortic media to create ruptured surfaces for all specimens. Peeling tests of the male ATAAs generate rougher surfaces than females. CONCLUSIONS There is a higher propensity of AD occurrence for the elderly females as compared to males with matched ages. Surgeons should be cognizant of the risk of AD onset later in life, especially in females.

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Angiologie

Regitz-Zagrosek

2023

Gendermedizin in Der Klinischen Praxis

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Sex-Based Aortic Dissection Outcomes From the International Registry of Acute Aortic Dissection

Cited by 60 publications

References 24 publications

Gender Differences in Acute Aortic Dissection

Gender Differences in Acute Aortic Dissection

Gender differences in the dissection properties of ascending thoracic aortic aneurysms

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