MiscellaneousType-Selective Benefits of Medications in Treatment of Acute Aortic Dissection (from the International Registry of Acute Aortic Dissection [IRAD])
Section snippets
Methods
IRAD is a multinational registry of 24 referral centers in 12 countries. The details of the IRAD structure and methods used have been previously published.20, 21, 22, 23, 24
Data from all patients with aortic dissection enrolled in IRAD from December 26, 1995 with follow-up to 5 years was examined, with a focus on patients discharged alive with medication and follow-up data that included the use of medications. The collected data included variables on clinical, imaging, and mortality data.
Results
For the 1,301 patients with acute aortic dissection who survived to discharge and had information on the medications at discharge and during follow-up (median 26.0 months, interquartile range 12.0 to 48.0), the blood pressure status on admission showed that a little >1/2 (50.2%) of all patients were hypertensive. Most of the patients with type B (70.1%) were hypertensive. In contrast, more of the patients with type A were normotensive (43.9%) than hypertensive (33.7%), with a significantly
Discussion
Acute aortic dissection involves blood flow through an intimal tear into the aortic media of an often weakened aortic wall resulting from degeneration (e.g., atherosclerosis, aging, hypertension) and/or genetic predisposition (e.g., Marfan syndrome). The underlying principle of treatment is to limit propagation of the false lumen and its negative consequences on end-organ perfusion by reducing and stabilizing the hemodynamic stress on the aortic wall.1, 2, 3, 4, 5, 6, 7, 8 Surgical repair is
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