Impact of Antithrombotic Therapy on Clinical Outcomes in Patients with Type B Acute Aortic Syndrome

Overview

Journal JTCVS Open

Specialty Cardiology & Vascular Diseases

Date 2023 Jul 10

PMID 37425476

Authors

Akiko Masumoto

Yuta Azumi

Shuichiro Kaji

Yutaro Miyoshi

Kitae Kim

Takeshi Kitai

Yutaka Furukawa

Affiliations

Soon will be listed here.

Abstract

Objective: Antithrombotic therapy has the potential to interfere with false lumen thrombosis. In type B acute aortic syndrome, the degree of false lumen thrombosis affects clinical outcomes. We aimed to explore the association of antithrombotic therapy with the prognosis of patients with type B acute aortic syndrome.

Methods: We reviewed 406 patients with type B acute aortic syndrome who were discharged alive with and without antithrombotic therapy. The primary outcome was aorta-related adverse events, defined as a composite of aorta-related death, aortic rupture, aortic repair, and progressive aortic dilation.

Results: Of the 406 patients, 64 (16%) were discharged with antithrombotic therapy and 342 (84%) were discharged without antithrombotic therapy. A total of 249 patients (61%) presented with intramural hematoma with complete thrombosis of the false lumen, and 157 patients (39%) presented with aortic dissection. During a median follow-up of 4.6 years, 32 patients (50%) in the antithrombotic group and 93 patients (27%) in the nonantithrombotic group had a primary outcome event. Cumulative incidence of aorta-related events at 1 and 3 years with death as the competing risk was higher in the antithrombotic group than in the nonantithrombotic group (19% ± 5% vs 9% ± 2% at 1 year and 40% ± 7% vs 17% ± 2% at 3 years, < .001).

Conclusions: Antithrombotic therapy might be associated with an increased risk of aorta-related events in patients with type B acute aortic syndrome.

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