Sex Differences in the Characteristics of Acute Aortic Dissection: Stanford Type A Dissection among Elderly Women in Japan.

OBJECTIVES

Acute aortic dissection (AAD) still remains a life-threatening medical emergency. However, only a few data exist on sex-related differences in patients with AAD over the recent years.

MATERIALS AND

METHODS

The medical records of 192 consecutive patients admitted to Juntendo University Urayasu Hospital from January 2008 to December 2021 who had been diagnosed with AAD were retrospectively collected. Thereafter, sex-related differences in patient characteristics, type of dissection, maximal diameters of dissection, the onset-to-arrival time, and short-term mortality were determined.

RESULTS

A total of 164 patients were ultimately enrolled in this study. Compared to men, women were significantly older, were less obese, and had lower prevalence of metabolic syndrome. A significantly higher proportion of women than men underwent Stanford type A dissections (52% vs. 25%), except among those aged 50 years and younger. Women had significantly larger maximal aortic dissection diameters compared to men (43.3 ± 9.5 vs. 38.9 ± 7.2 mm). Women with type A dissection were older, had lower body mass index and albumin levels compared to men, and demonstrated poorer renal function than women with type B dissection.

CONCLUSION

In the context of Japan's aging society, older, underweight women with chronic kidney disease and malnutrition may represent a high-risk population for Stanford type A aortic dissection.