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Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control

Background and Aims: The contradiction of management modality between acute myocardial infarction(AMI) and aortic dissection(AD) may result in clinical catastrophe. Data on risk factors, incidence, and outcome of AD and AMI are limited, and there have been no studies on the long-term outcomes of AMI...

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Autores principales: Liu, Fang, Qian, Si-Chong, Jing, Shuai, Wang, Zhe, Yang, Xin-Chun, Chen, Mu-Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459711/
https://www.ncbi.nlm.nih.gov/pubmed/34568411
http://dx.doi.org/10.3389/fsurg.2021.678806
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author Liu, Fang
Qian, Si-Chong
Jing, Shuai
Wang, Zhe
Yang, Xin-Chun
Chen, Mu-Lei
author_facet Liu, Fang
Qian, Si-Chong
Jing, Shuai
Wang, Zhe
Yang, Xin-Chun
Chen, Mu-Lei
author_sort Liu, Fang
collection PubMed
description Background and Aims: The contradiction of management modality between acute myocardial infarction(AMI) and aortic dissection(AD) may result in clinical catastrophe. Data on risk factors, incidence, and outcome of AD and AMI are limited, and there have been no studies on the long-term outcomes of AMI in patients with AD. So we aimed to investigate long-term outcomes after AMI in patients with AD, and propose a useful diagnostic paradigm. Methods: Consecutively enrolled patients with AD and AMI who were referred to our center from 2010 to 2017. Baseline patient characteristics, risk factors, all medical treatments, echocardiographic parameters, laboratory data, and treatment were recorded. All patients were followed up from the first hospitalization until a first heart event, death, or 17 March, 2018. Results: 0.13% in AMI and 7.49% in AD patients had a concomitant diagnosis of AD and AMI. The average patient age was 53.3 ± 12.1 years and 84.6% were male. The most prevalent vascular risk factors were hypertension (69.2%) and current smoker (64.1%). Of all the 39 patients, 66.7% were managed surgically. Overall in-hospital mortality was 10.3%. The 30-day and 5-year fatality rates were 23.1% and 35.9%, but were higher for female than for male (66.7 vs. 30.3%, log-rank P = 0.045) on 5-year mortality. The overall survival of females was inferior to the males (log-rank P = 0.045). Conclusions: Patients with AMI and AD exhibit high 5-year fatality rates. For these patients, surgical management tends to have lower mortality. Improved management of hypertension and smoking, may reduce future incidence rates.
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spelling pubmed-84597112021-09-24 Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control Liu, Fang Qian, Si-Chong Jing, Shuai Wang, Zhe Yang, Xin-Chun Chen, Mu-Lei Front Surg Surgery Background and Aims: The contradiction of management modality between acute myocardial infarction(AMI) and aortic dissection(AD) may result in clinical catastrophe. Data on risk factors, incidence, and outcome of AD and AMI are limited, and there have been no studies on the long-term outcomes of AMI in patients with AD. So we aimed to investigate long-term outcomes after AMI in patients with AD, and propose a useful diagnostic paradigm. Methods: Consecutively enrolled patients with AD and AMI who were referred to our center from 2010 to 2017. Baseline patient characteristics, risk factors, all medical treatments, echocardiographic parameters, laboratory data, and treatment were recorded. All patients were followed up from the first hospitalization until a first heart event, death, or 17 March, 2018. Results: 0.13% in AMI and 7.49% in AD patients had a concomitant diagnosis of AD and AMI. The average patient age was 53.3 ± 12.1 years and 84.6% were male. The most prevalent vascular risk factors were hypertension (69.2%) and current smoker (64.1%). Of all the 39 patients, 66.7% were managed surgically. Overall in-hospital mortality was 10.3%. The 30-day and 5-year fatality rates were 23.1% and 35.9%, but were higher for female than for male (66.7 vs. 30.3%, log-rank P = 0.045) on 5-year mortality. The overall survival of females was inferior to the males (log-rank P = 0.045). Conclusions: Patients with AMI and AD exhibit high 5-year fatality rates. For these patients, surgical management tends to have lower mortality. Improved management of hypertension and smoking, may reduce future incidence rates. Frontiers Media S.A. 2021-09-09 /pmc/articles/PMC8459711/ /pubmed/34568411 http://dx.doi.org/10.3389/fsurg.2021.678806 Text en Copyright © 2021 Liu, Qian, Jing, Wang, Yang and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Liu, Fang
Qian, Si-Chong
Jing, Shuai
Wang, Zhe
Yang, Xin-Chun
Chen, Mu-Lei
Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control
title Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control
title_full Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control
title_fullStr Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control
title_full_unstemmed Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control
title_short Incidence and Outcome of Acute Myocardial Infarction in Patients With Aortic Dissection and Risk Factor Control
title_sort incidence and outcome of acute myocardial infarction in patients with aortic dissection and risk factor control
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459711/
https://www.ncbi.nlm.nih.gov/pubmed/34568411
http://dx.doi.org/10.3389/fsurg.2021.678806
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