Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD).

Abstract:

OBJECTIVES:The goal of this study was to better characterize the young patient with aortic dissection (AoD). BACKGROUND:Aortic dissection is unusual in young patients, and frequently associated with unusual presentations. METHODS:Data were collected on 951 patients diagnosed with AoD between January 1996 and November 2001. Two categories of patients, <40 years and >or=40 years, were compared using chi-square cross tabulations for categorical and Student t test for continuous data. RESULTS:Sixty-eight patients (7%) with AoD were <40 years of age. Compared with patients >or=40 years, younger patients were less likely to have a prior history of hypertension (p < 0.05); however, younger patients were more likely to have Marfan syndrome, bicuspid aortic valve, and prior aortic surgery (all, p < 0.05). Clinical presentations in the two age groups were similar; however, younger patients were less likely to be hypertensive (25% vs. 45%, p = 0.003). The proximal aortas of young AoD patients were larger (all, p < 0.05) compared with older patients. These differences in aortic size between age groups were not entirely related to Marfan syndrome. Mortality among young patients was similar to patients >or=40 years of age (22% vs. 24%, p = NS), irrespective of the site of dissection. CONCLUSIONS:Compared with older patients with AoD, young patients have unique risk factors for dissection: Marfan syndrome, bicuspid aortic valves, and larger aortic dimensions. Surprisingly, the mortality risk for young AoD patients is not lower than older AoD patients.

journal_name

J Am Coll Cardiol

authors

Januzzi JL,Isselbacher EM,Fattori R,Cooper JV,Smith DE,Fang J,Eagle KA,Mehta RH,Nienaber CA,Pape LA,International Registry of Aortic Dissection (IRAD).

doi

10.1016/j.jacc.2003.08.054

subject

Has Abstract

pub_date

2004-02-18 00:00:00

pages

665-9

issue

4

eissn

0735-1097

issn

1558-3597

pii

S0735109703015614

journal_volume

43

pub_type

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