Prevalence and impact of concomitant coronary artery disease in aged patients with Stanford type B aortic dissection / 中华胸心血管外科杂志

ABSTRACT

Objective To evaluate the prevalence and impact of coronary artery disease (CAD) in aged patients with Stanford type B aortic dissection(AD).Methods From January 2008 to December 2011,CAG was routinely performed before aortography and thoracic aortic repair(TEVAR) to determine the prevalence of concomitant CAD in 200 consecutive Stanford type B AD patients who were older than 50 years.All patients received 1 year follow-up.Adverse events were compared between patients with and without concomitant CAD.Data analysis by SPSS 17.0 statistical software,using Student t test,Chi-square test and Fisher exact test.Results CAG showed 53 patients (26.5％) had CAD.Multivariate logistic regression analysis showed that male gender(OR =4.415,95％ CI1.131-17.237,P =0.033) and age (OR =1.061,95％ CI1.017-1.108,P =0.006) were independent predictors of Stanford type BAD coexisted with CAD.Age was also independent predictor of multi-vessel disease(MVD) and/or left main disease(LMD) (OR =1.096,95％ CI1.009-1.191,P =0.023).At 30-day follow-up,there was no difference in the incidence of adverse events between patients with and without concomitant CAD.Patients with concomitant CAD showed higher incidence of myocardial infarction[3 (5.66％) vs.0(0),P =0.018] and stroke [4 (7.55 ％) vs.1 (0.68 ％),P =0.018].Conclusion The prevalence of CAD in aged patients with Stanford type BAD is relatively high.Concomitant CAD is associated with higher risk of cardio-cerebrovascular ischemic events while dose not increase the risk of adverse aorta related events.