Population-based incidence and outcomes of acute aortic dissection in Japan

European Heart Journal: Acute Cardiovascular Care - Tập 10 Số 7 - Trang 701-709 - 2021
Tetsuo Yamaguchi1, Michikazu Nakai2, Takao Yano3, Masakazu Matsuyama4, Hideaki Yoshino5, Yoshihiro Miyamoto2, Yoko Sumita2, Hitoshi Matsuda6, Yousuke Inoue6, Yutaka Okita7, Kenji Minatoya8, Yuichi Ueda9, Hitoshi Ogino10
1Department of Cardiovascular Center, Toranomon Hospital, 2-2-2, Toranomon, Minato-ku, Tokyo, 105-8470, Japan
2Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, 6-1, Kishibe-shinmachi, Suita city, Osaka 565-8565, Japan
3Department of Critical Care and Emergency Medicine, Miyazaki Prefectural Nobeoka Hospital, 2-1-10, Shin-koji, Nobeoka City, Miyazaki 882-0835, JAPAN
4Department of Cardiovascular Surgery, Miyazaki Prefectural Nobeoka hospital, 2-1-10, Shin-koji, Nobeoka city, Miyazaki 882-0835, Japan
5Department of Cardiology, Kyorin University Graduate School of Medicine, 20-2, Shinkawa, Mitaka city, Tokyo 181-8611, Japan
6Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 6-1, Kishibe-shinmachi, Suita city, Osaka 565-8565, Japan
7Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, 7-5-2, Kusunokicho, chuo-ku, Kobe city, Hyogo 650-0017, Japan
8Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54, Shogoin-Kawaramachi, Sakyo-ku, Kyoto 606-8507, Japan
9Department of Cardiology, Nara Prefecture General Medical Center, 2-897-5, Shichijo-Nishimachi, Nara 630-8581, Japan
10Department of Cardiovascular Surgery, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan

Tóm tắt

Abstract Aims The population-based incidence and outcomes of acute aortic dissection (AAD) are still unknown because some patients are already dead on arrival, and the accurate diagnosis of AAD is difficult due to the low autopsy rate. We performed a population-based review of all patients with AAD in a well-defined geographical area in Japan between 2016 and 2018. Methods and results Data of all patients with AAD at Miyazaki Prefectural Nobeoka Hospital (MPNH), which performs medical care for 120 000 residents, were collected retrospectively. The emergency medical service is dedicated to the transfer of all patients in this area to the MPNH. For all patients who were dead on arrival, the diagnosis of AAD was made by autopsy imaging (AI) using computed tomography. The age-adjusted incidence and mortality per 100 000 population were calculated using the Japanese population distribution model in 2015. The total incidence of AAD was 79 (type A: 64.5%, n = 51). Of those, 60.8% (31/51) of patients with type A and 21.4% (6/28) with type B were dead on arrival and diagnosed by AI. The 30-day mortality rates were 74.5% (38/51) in type A and 25.0% (7/28) in type B. The age-adjusted incidence and mortality of AAD per 100 000 inhabitants were 17.6 (type A: 11.3, type B: 6.2) and 9.9 (type A: 8.4, type B: 1.5), respectively. Conclusions The population-based survey of AAD showed that the age-adjusted incidence of AAD was two-fold higher than in previous reports, and the actual mortality rates were markedly higher due to the high incidence of dead-on-arrival.

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Tài liệu tham khảo

Hagan, 2000, The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease, JAMA, 283, 897, 10.1001/jama.283.7.897

Nienaber, 2003, Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies, Circulation, 108, 628, 10.1161/01.CIR.0000087009.16755.E4

2018, Insights from the International Registry of Acute Aortic Dissection: A 20-year experience of collaborative clinical research, Circulation, 137, 1846, 10.1161/CIRCULATIONAHA.117.031264

Evangelista, 2018, Diagnosis, management and mortality in acute aortic syndrome: Results of the Spanish Registry of Acute Aortic Syndrome (RESA-II), Eur Heart J Acute Cardiovasc Care, 7, 602, 10.1177/2048872616682343

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. Eur Heart J Acute Cardiovasc Care. 2020 Oct;9(3_suppl):S21–S31.

Howard, 2013, Population-based study of incidence and outcome of acute aortic dissection and premorbid risk factor control: 10-year results from the Oxford Vascular Study, Circulation, 127, 2031, 10.1161/CIRCULATIONAHA.112.000483

Smedberg, 2020, Sex differences and temporal trends in aortic dissection: a population-based study of incidence, treatment strategies, and outcome in Swedish patients during 15 years, Eur Heart J, 41, 2430, 10.1093/eurheartj/ehaa446

2014, 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases, Eur Heart J, 35, 2873, 10.1093/eurheartj/ehu281

Salvolini, 2008, Acute aortic syndromes: role of multi-detector row CT, Eur J Radiol, 65, 350, 10.1016/j.ejrad.2007.09.020

2001, Diagnosis and management of aortic dissection, Eur Heart J, 22, 1642

Miller, 1979, Operative treatment of aortic dissections. Experience with 125 patients over a sixteen-year period, J Thorac Cardiovasc Surg, 78, 365

Sebastià, 1999, Aortic dissection: diagnosis and follow-up with helical CT, Radiographics, 19, 45, 10.1148/radiographics.19.1.g99ja0945

Demos, 1986, Detection of the intimal flap of aortic dissection on unenhanced CT images, AJR Am J Roentgenol, 146, 601, 10.2214/ajr.146.3.601

Kurabayashi, 2014, Diagnostic utility of unenhanced computed tomography for acute aortic syndrome, Circ J, 78, 1928, 10.1253/circj.CJ-14-0198

2015

Knipp, 2007, A contemporary analysis of outcomes for operative repair of type A aortic dissection in the United States, Surgery, 142, 524, 10.1016/j.surg.2007.07.012

Chikwe, 2013, National outcomes in acute aortic dissection: influence of surgeon and institutional volume on operative mortality, Ann Thorac Surg, 95, 1563, 10.1016/j.athoracsur.2013.02.039

Kumar, 2016, Weekend hospitalizations for acute aortic dissection have a higher risk of in-hospital mortality compared to weekday hospitalizations, Int J Cardiol, 214, 448, 10.1016/j.ijcard.2016.03.187

Shah, 2014, Nationwide comparative impact of thoracic endovascular aortic repair of acute uncomplicated type B aortic dissections, Vasc Endovascular Surg, 48, 230, 10.1177/1538574413518122

Takeuchi, 2020, Incidence and characteristics of acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest evaluated by non-contrast computed tomography, Eur Heart J Acute Cardiovasc Care, 9, S48, 10.1177/2048872620923647

Tanaka, 2016, Prevalence of type A acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest, Am J Cardiol, 117, 1826, 10.1016/j.amjcard.2016.03.015

2002, Circadian, weekly, and seasonal variation at the onset of acute aortic dissection, Am J Cardiol, 89, 619, 10.1016/S0002-9149(01)02311-6

Mehta, 2002, Chronobiological patterns of acute aortic dissection, Circulation, 106, 1110, 10.1161/01.CIR.0000027568.39540.4B

Kojima, 2002, Triggers and circadian distribution of the onset of acute aortic dissection, Circ J, 66, 232, 10.1253/circj.66.232

Portaluppi, 1999, From a static to a dynamic concept of risk: the circadian epidemiology of cardiovascular events, Chronobiology International, 16, 33, 10.3109/07420529908998710

Manfredini, 2004, Influence of circadian rhythm on mortality after myocardial infarction: data from a prospective cohort of emergency calls, Am J Emerg Med, 22, 555, 10.1016/j.ajem.2004.08.014

Marsh, 1990, Circadian variation in onset of acute ischemic stroke, Archives of Neurology, 47, 1178, 10.1001/archneur.1990.00530110032012

Booher, 2013, The IRAD classification system for characterizing survival after aortic dissection, Am J Med, 126, 730.e19, 10.1016/j.amjmed.2013.01.020

Inoue, 2020, Analysis of acute type A aortic dissection in Japan Registry of Aortic Dissection (JRAD), Ann Thorac Surg, 110, 790, 10.1016/j.athoracsur.2019.12.051

Landenhed, 2015, Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study, J Am Heart Assoc, 4, e001513, 10.1161/JAHA.114.001513

Hata, 2012, Sleep disorders and aortic dissection in a working population, Surgery Today, 42, 403, 10.1007/s00595-011-0060-1

Delsart, 2016, Prognostic Significance of Sleep Apnea Syndrome on False Lumen Aortic Expansion in Post-Acute Aortic Syndrome, The Annals of Thoracic Surgery, 102, 1558, 10.1016/j.athoracsur.2016.03.102

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European Heart Journal: Acute Cardiovascular Care

Tập 10 Số 7

701-709

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