Document Detail


Angiotensin-converting enzyme inhibitors reduce long-term aortic events in patients with acute type B aortic dissection.
MedLine Citation:
PMID:  18827369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Medical therapy gives excellent short-term outcomes for patients with Stanford type B acute aortic dissection. However, the affected aorta is often compromised by aneurysmal dilatation and rupture, resulting in poor long-term outcome. The present study investigated which antihypertensive treatment may prevent long-term aortic events in these patients. METHODS AND RESULTS: The study group comprised 78 consecutive patients with Stanford type B acute aortic dissection who were treated medically and followed-up for an average of 873+/-548 days. The optimal hypertensive drug regimen to reduce aortic events was determined by multivariate analyses. Of the 78 patients, 73 (94%) were discharged from hospital with medical therapy, and aortic events occurred in 13 (18%) of them (aortic rupture/recurrent dissection in 2 (3%); aortic expansion >or=60 mm in 7 (10%), rapid aortic expansion >or=10 mm/year in 3 (4%), and development of visceral/limb ischemia in 1 (1%)) during follow-up. By multivariate analysis, patients given angiotensin-converting enzyme inhibitor (ACEI) were less likely to have long-term aortic events than those without (odds ratio: 0.18, 95% confidence interval: 0.04-0.85). CONCLUSIONS: Use of ACEI is associated with a reduced risk of long-term aortic events in patients with medically treated type B aortic dissection.
Authors:
Satoshi Takeshita; Shingo Sakamoto; Shuichi Kitada; Koichi Akutsu; Hideki Hashimoto
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-09-29
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  72     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-24     Completed Date:  2008-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1758-61     Citation Subset:  IM    
Affiliation:
Department of Cardiology, National Cardiovascular Center, Suita, Japan. stake@muse.ocn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Aortic Rupture / mortality*,  therapy*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Middle Aged
Survival Rate
Time Factors
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors

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