Current status of the management and outcomes of acute aortic dissection in Japan: Analyses of nationwide Japanese Registry of All Cardiac and Vascular Diseases-Diagnostic Procedure Combination data.


Journal

European heart journal. Acute cardiovascular care
ISSN: 2048-8734
Titre abrégé: Eur Heart J Acute Cardiovasc Care
Pays: England
ID NLM: 101591369

Informations de publication

Date de publication:
Oct 2020
Historique:
pubmed: 29 8 2019
medline: 24 6 2021
entrez: 29 8 2019
Statut: ppublish

Résumé

Despite recent advances in the diagnosis and management, the mortality of acute aortic dissection remains high. This study aims to clarify the current status of the management and outcome of acute aortic dissection in Japan. A total of 18,348 patients with acute aortic dissection (type A: 10,131, type B: 8217) in the Japanese Registry of All Cardiac and Vascular Diseases database between April 2012-March 2015 were studied. Characteristics, clinical presentation, management, and in-hospital outcomes were analyzed. Seasonal onset variation (autumn- and winter-dominant) was found in both types. More than 90% of patients underwent computed tomography for primary diagnosis. The overall in-hospital mortality of types A and B was 24.3% and 4.5%, respectively. The mortality in type A patients managed surgically was significantly lower than in those not receiving surgery (11.8% (799/6788) vs 49.7% (1663/3343); This nationwide study elucidated the clinical features and outcomes in contemporary patients with acute aortic dissections in real-world clinical practice in Japan.

Sections du résumé

BACKGROUND BACKGROUND
Despite recent advances in the diagnosis and management, the mortality of acute aortic dissection remains high. This study aims to clarify the current status of the management and outcome of acute aortic dissection in Japan.
METHODS METHODS
A total of 18,348 patients with acute aortic dissection (type A: 10,131, type B: 8217) in the Japanese Registry of All Cardiac and Vascular Diseases database between April 2012-March 2015 were studied. Characteristics, clinical presentation, management, and in-hospital outcomes were analyzed.
RESULTS RESULTS
Seasonal onset variation (autumn- and winter-dominant) was found in both types. More than 90% of patients underwent computed tomography for primary diagnosis. The overall in-hospital mortality of types A and B was 24.3% and 4.5%, respectively. The mortality in type A patients managed surgically was significantly lower than in those not receiving surgery (11.8% (799/6788) vs 49.7% (1663/3343);
CONCLUSIONS CONCLUSIONS
This nationwide study elucidated the clinical features and outcomes in contemporary patients with acute aortic dissections in real-world clinical practice in Japan.

Identifiants

pubmed: 31460772
doi: 10.1177/2048872619872847
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

S21-S31

Auteurs

Tetsuo Yamaguchi (T)

Department of Cardiovascular Center, Toranomon Hospital, Japan.

Michikazu Nakai (M)

Department of Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Japan.

Yoko Sumita (Y)

Department of Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Japan.

Yoshihiro Miyamoto (Y)

Department of Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Japan.

Hitoshi Matsuda (H)

Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Japan.

Yousuke Inoue (Y)

Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Japan.

Hideaki Yoshino (H)

Department of Cardiology, Kyorin University Graduate School of Medicine, Japan.

Yutaka Okita (Y)

Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Japan.

Kenji Minatoya (K)

Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Japan.

Yuichi Ueda (Y)

Department of Cardiology, Nara Prefecture General Medical Center, Japan.

Hitoshi Ogino (H)

Department of Cardiovascular Surgery, Tokyo Medical University, Japan.

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Classifications MeSH