Haider Alkhateeb, Sarmad Said, Chad J. Cooper, Carlos Rodriguez-Castro, Alok Dwivedi, Eduardo Onate, Raphael Quansah, Debabrata Mukherjee
Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
Med Sci Monit 2014; 20:747-751
Acute aortic dissection (AAD) is a life-threatening cardiovascular condition with high morbidity and mortality.
We sought to assess clinical profiles as well as outcomes of AAD in a predominantly Hispanic population and to explore the relationship between this condition and uncontrolled/untreated hypertension in this community.
Material and Methods: This was a single-center, retrospective, cross-sectional study of patients admitted with AAD over a 10 years period.
Results: Fifty-nine cases of AAD were included in the analysis. The group of Hispanics with AAD had more females (48.3%, p=0.002), more dyslipidemia and coronary artery disease (p=0.006 and 0.05, respectively), and a tendency to be older and have more hypertension and diabetes compared to non-Hispanics. Although 70.2% of all patients had hypertension, only 52.5% of them were being treated; of those, only 66.7% achieved optimal blood pressure control prior to presentation. Only 47.4% received beta-blockers for blood pressure control in the acute setting. Longer length of in-hospital stay was associated with older age, higher troponin and creatine kinase levels, and presence of hypertension. In-hospital death occurred in 10 (17%) patients and mortality was significantly associated with higher serum creatinine (p=0.01).
Conclusions: Hispanic patients with AAD were more likely to be female, of older age, and have more cardiovascular risk factors in comparison to non-Hispanics. In addition, significant under-treatment of hypertension in this population and underutilization of beta-blockers for blood pressure control in the acute settings was evident. Better prevention and timely treatment may improve outcomes for this condition in this population.
Keywords: Aneurysm, Dissecting - therapy, Acute Disease, Aortic Aneurysm - therapy, Female, Hispanic Americans, Humans, Male, Middle Aged, Multimodal Imaging, Treatment Outcome