Postgraduate medical journal · 2011
Comparison of aortic dissection in Chinese patients with and without Marfan syndrome.
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Linggen Gao, Lin Zhang, Xiaohan Fan, Haiying Wu, Xianliang Zhou, Rutai Hui
Аннотация
BACKGROUND: Aortic dissection is a life-threatening cardiovascular disease with high mortality. Little is known about comparisons of the clinical characteristics or the factors that influence the long-term prognosis of Chinese patients with aortic dissection with and without Marfan syndrome (MFS).
METHODS: The authors studied the data of 246 patients with aortic dissection. The patients were hospitalised for aortic abnormalities from 2004 to 2008 in Fuwai Hospital. Medical charts were reviewed to obtain clinical data using a standardised data collection sheet.
RESULTS: Of the 246 patients with acute aortic dissection, 56 had MFS. Compared with the non-MFS patients, those with MFS were considerably younger (mean ± SD age 35.27 ± 11.11 vs 54.11 ± 11.96 years, p<0.001) and had pre-existing hypertension much less commonly (5.4% vs 80.0%, p<0.001). The patients with MFS presented with a wider ascending aorta diameter (63.60 ± 9.00 vs 38.55 ± 9.44 mm, p<0.001) and a lower body mass index (20.14 ± 2.00 vs 25.62 ± 3.41, p<0.001) than the non-MFS patients. Overall, 91.1% of the MFS patients underwent surgical treatment, whereas 55.78% of the non-MFS patients accepted medical treatment. However, mortality in the two groups did not differ significantly (6 vs 17, p=0.527). Multivariate analysis showed that the aortic diameter (OR=1.072) was a risk factor and surgical treatment (OR=0.006) was a protective factor for the survival of MFS patients with aortic dissection. With increased diastolic blood pressure, mortality decreased in non-MFS patients with aortic dissection (OR=0.905).
CONCLUSIONS: These clinical results could be useful for rapid assessment of the treatment and prognosis of patients with aortic dissection.
METHODS: The authors studied the data of 246 patients with aortic dissection. The patients were hospitalised for aortic abnormalities from 2004 to 2008 in Fuwai Hospital. Medical charts were reviewed to obtain clinical data using a standardised data collection sheet.
RESULTS: Of the 246 patients with acute aortic dissection, 56 had MFS. Compared with the non-MFS patients, those with MFS were considerably younger (mean ± SD age 35.27 ± 11.11 vs 54.11 ± 11.96 years, p<0.001) and had pre-existing hypertension much less commonly (5.4% vs 80.0%, p<0.001). The patients with MFS presented with a wider ascending aorta diameter (63.60 ± 9.00 vs 38.55 ± 9.44 mm, p<0.001) and a lower body mass index (20.14 ± 2.00 vs 25.62 ± 3.41, p<0.001) than the non-MFS patients. Overall, 91.1% of the MFS patients underwent surgical treatment, whereas 55.78% of the non-MFS patients accepted medical treatment. However, mortality in the two groups did not differ significantly (6 vs 17, p=0.527). Multivariate analysis showed that the aortic diameter (OR=1.072) was a risk factor and surgical treatment (OR=0.006) was a protective factor for the survival of MFS patients with aortic dissection. With increased diastolic blood pressure, mortality decreased in non-MFS patients with aortic dissection (OR=0.905).
CONCLUSIONS: These clinical results could be useful for rapid assessment of the treatment and prognosis of patients with aortic dissection.