PMID- 38156593 OWN - NLM STAT- MEDLINE DCOM- 20240104 LR - 20240215 IS - 2047-9980 (Electronic) IS - 2047-9980 (Linking) VI - 13 IP - 1 DP - 2024 Jan 2 TI - Male-Female Differences in Acute Type B Aortic Dissection. PG - e029258 LID - 10.1161/JAHA.122.029258 [doi] LID - e029258 AB - BACKGROUND: Acute type B aortic dissection is a cardiovascular emergency with considerable mortality and morbidity risk. Male-female differences have been observed in cardiovascular disease; however, literature on type B aortic dissection is scarce. METHODS AND RESULTS: A retrospective cohort study was conducted including all consecutive patients with acute type B aortic dissection between 2007 and 2017 in 4 tertiary hospitals using patient files and questionnaires for late morbidity. In total, 384 patients were included with a follow-up of 6.1 (range, 0.02-14.8) years, of which 41% (n=156) were female. Women presented at an older age than men (67 [interquartile range (IQR), 57-73] versus 62 [IQR, 52-71]; P=0.015). Prior abdominal aortic aneurysm (6% versus 15%; P=0.009), distally extending dissections (71 versus 85%; P=0.001), and clinical malperfusion (18% versus 32%; P=0.002) were less frequently observed in women. Absolute maximal descending aortic diameters were smaller in women (36 [IQR: 33-40] mm versus 39 [IQR, 36-43] mm; P<0.001), while indexed for body surface area diameters were larger in women (20 [IQR, 18-23] mm/m(2) versus 19 [IQR, 17-21] mm/m(2)). No male-female differences were found in treatment choice; however, indications for invasive treatment were different (P<0.001). Early mortality rate was 9.6% in women and 11.8% in men (P=0.60). The 5-year survival was 83% (95% CI, 77-89) for women and 84% (95% CI, 79-89) for men (P=0.90). No male-female differences were observed in late (re)interventions. CONCLUSIONS: No male-female differences were found in management, early or late death, and morbidity in patients presenting with acute type B aortic dissection, despite distinct clinical profiles at presentation. More details on the impact of age and type of intervention are warranted in future studies. FAU - Meccanici, Frederike AU - Meccanici F AUID- ORCID: 0000-0003-3244-8195 AD - Department of Cardiology Erasmus University Medical Center Rotterdam Netherlands. FAU - Thijssen, Carlijn G E AU - Thijssen CGE AD - Department of Cardiology Erasmus University Medical Center Rotterdam Netherlands. AD - Department of Cardiology Radboud University Medical Center Nijmegen Netherlands. FAU - Heijmen, Robin H AU - Heijmen RH AD - Department of Cardiothoracic Surgery St. Antonius Hospital Nieuwegein Netherlands. FAU - Geuzebroek, Guillaume S C AU - Geuzebroek GSC AUID- ORCID: 0000-0003-0407-2901 AD - Department of Cardiothoracic Surgery Radboud University Medical Center Nijmegen Netherlands. FAU - Ter Woorst, Joost F AU - Ter Woorst JF AUID- ORCID: 0000-0003-1886-4045 AD - Department of Cardiothoracic Surgery Catharina Hospital Eindhoven Netherlands. FAU - Gokalp, Arjen L AU - Gokalp AL AUID- ORCID: 0000-0001-8126-6844 AD - Department of Cardiothoracic Surgery Erasmus University Medical Center Rotterdam Netherlands. FAU - de Bruin, Jorg L AU - de Bruin JL AD - Department of Vascular Surgery Erasmus University Medical Center Rotterdam Netherlands. FAU - Gratama, Daantje N AU - Gratama DN AD - Department of Vascular Surgery Erasmus University Medical Center Rotterdam Netherlands. FAU - Bekkers, Jos A AU - Bekkers JA AD - Department of Cardiothoracic Surgery Erasmus University Medical Center Rotterdam Netherlands. FAU - van Kimmenade, Roland R J AU - van Kimmenade RRJ AD - Department of Cardiology Erasmus University Medical Center Rotterdam Netherlands. AD - Department of Cardiology Radboud University Medical Center Nijmegen Netherlands. FAU - Poyck, Paul AU - Poyck P AD - Department of Vascular Surgery Radboud University Medical Center Nijmegen Netherlands. FAU - Peels, Kathinka AU - Peels K AUID- ORCID: 0000-0001-8932-9491 AD - Department of Cardiology Catharina Hospital Eindhoven Netherlands. FAU - Post, Marco C AU - Post MC AD - Department of Cardiology St. Antonius Hospital Nieuwegein Netherlands. AD - Department of Cardiology University Medical Center Utrecht Utrecht Netherlands. FAU - Mokhles, Mostafa M AU - Mokhles MM AD - Department of Cardiothoracic Surgery Erasmus University Medical Center Rotterdam Netherlands. AD - Department of Cardiothoracic Surgery University Medical Center Utrecht Utrecht Netherlands. FAU - Takkenberg, Johanna J M AU - Takkenberg JJM AUID- ORCID: 0000-0001-9809-5623 AD - Department of Cardiothoracic Surgery Erasmus University Medical Center Rotterdam Netherlands. FAU - Roos-Hesselink, Jolien W AU - Roos-Hesselink JW AUID- ORCID: 0000-0002-6770-3830 AD - Department of Cardiology Erasmus University Medical Center Rotterdam Netherlands. FAU - Verhagen, Hence J M AU - Verhagen HJM AD - Department of Vascular Surgery Erasmus University Medical Center Rotterdam Netherlands. LA - eng PT - Journal Article DEP - 20231229 PL - England TA - J Am Heart Assoc JT - Journal of the American Heart Association JID - 101580524 SB - IM MH - Humans MH - Male MH - Female MH - *Aortic Aneurysm, Thoracic/surgery MH - Retrospective Studies MH - *Blood Vessel Prosthesis Implantation MH - Treatment Outcome MH - *Aortic Dissection/epidemiology MH - Acute Disease MH - *Endovascular Procedures MH - Risk Factors PMC - PMC10863826 OTO - NOTNLM OT - Stanford type B dissection OT - gender OT - sex OT - thoracic aortic dissection EDAT- 2023/12/29 06:43 MHDA- 2024/01/04 11:44 PMCR- 2024/01/02 CRDT- 2023/12/29 05:53 PHST- 2024/01/04 11:44 [medline] PHST- 2023/12/29 06:43 [pubmed] PHST- 2023/12/29 05:53 [entrez] PHST- 2024/01/02 00:00 [pmc-release] AID - JAH38754 [pii] AID - 10.1161/JAHA.122.029258 [doi] PST - ppublish SO - J Am Heart Assoc. 2024 Jan 2;13(1):e029258. doi: 10.1161/JAHA.122.029258. Epub 2023 Dec 29.