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07 May 2014 : Original article

Clinical profiles and outcomes of acute aortic dissection in a predominantly Hispanic population

Haider AlkhateebABCDEF, Sarmad SaidABCDEF, Chad J. CooperABCDE, Carlos Rodriguez-CastroABCD, Alok DwivediCD, Eduardo OnateABCD, Raphael QuansahABC, Debabrata MukherjeeABCDEF

DOI: 10.12659/MSM.890456

Med Sci Monit 2014; 20:747-751

Abstract

BACKGROUND: 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, Hispanic Americans, Multimodal Imaging

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750