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Type-Selective Benefits of Medications in Treatment of Acute Aortic Dissection (from the International Registry of Acute Aortic Dissection [IRAD])

The effects of medications on the outcome of aortic dissection remain poorly understood. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with... Full description

Journal Title: The American journal of cardiology 2012, Vol.109 (1), p.122-127
Main Author: Suzuki, Toru, MD
Other Authors: Isselbacher, Eric M., MD , Nienaber, Christoph A., MD , Pyeritz, Reed E., MD , Eagle, Kim A., MD , Tsai, Thomas T., MD , Cooper, Jeanna V., MS , Januzzi, James L., MD , Braverman, Alan C., MD , Montgomery, Daniel G., BS , Fattori, Rossella, MD , Pape, Linda, MD , Harris, Kevin M., MD , Booher, Anna, MD , Oh, Jae K., MD , Peterson, Mark, MD , Ramanath, Vijay S., MD , Froehlich, James B., MD
Format: Electronic Article Electronic Article
Language: English
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Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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recordid: cdi_proquest_miscellaneous_912110690
title: Type-Selective Benefits of Medications in Treatment of Acute Aortic Dissection (from the International Registry of Acute Aortic Dissection [IRAD])
format: Article
creator:
  • Suzuki, Toru, MD
  • Isselbacher, Eric M., MD
  • Nienaber, Christoph A., MD
  • Pyeritz, Reed E., MD
  • Eagle, Kim A., MD
  • Tsai, Thomas T., MD
  • Cooper, Jeanna V., MS
  • Januzzi, James L., MD
  • Braverman, Alan C., MD
  • Montgomery, Daniel G., BS
  • Fattori, Rossella, MD
  • Pape, Linda, MD
  • Harris, Kevin M., MD
  • Booher, Anna, MD
  • Oh, Jae K., MD
  • Peterson, Mark, MD
  • Ramanath, Vijay S., MD
  • Froehlich, James B., MD
subjects:
  • Abridged Index Medicus
  • ACE inhibitors
  • Acute Disease
  • Adrenergic beta blockers
  • Adrenergic beta-Antagonists - therapeutic use
  • Aged
  • Analysis
  • Aneurysm, Dissecting - diagnosis
  • Aneurysm, Dissecting - mortality
  • Aneurysm, Dissecting - therapy
  • Aortic Aneurysm, Thoracic - diagnosis
  • Aortic Aneurysm, Thoracic - mortality
  • Aortic Aneurysm, Thoracic - therapy
  • aortic dissection
  • Beta blockers
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Calcium
  • Calcium channel blockers
  • Cardiology. Vascular system
  • Cardiovascular
  • Cause of Death - trends
  • Diagnostic Imaging
  • Diseases of the aorta
  • Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
  • Dissecting aneurysm
  • Drug therapy
  • Enzyme inhibitors
  • Enzymes
  • Female
  • Follow-Up Studies
  • Global Health
  • Health aspects
  • Humans
  • Male
  • Medical colleges
  • Medical sciences
  • Mortality
  • Prognosis
  • Retrospective Studies
  • Surgery
  • Survival analysis
  • Survival Rate - trends
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures
ispartof: The American journal of cardiology, 2012, Vol.109 (1), p.122-127
description: The effects of medications on the outcome of aortic dissection remain poorly understood. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with type B) with information on their medications at discharge and followed for ≤5 years were analyzed for the effects of the medications on mortality. The initial univariate analysis showed that use of β blockers was associated with improved survival in all patients (p = 0.03), in patients with type A overall (p = 0.02), and in patients with type A who received surgery (p = 0.006). The analysis also showed that use of calcium channel blockers was associated with improved survival in patients with type B overall (p = 0.02) and in patients with type B receiving medical management (p = 0.03). Multivariate models also showed that the use of β blockers was associated with improved survival in those with type A undergoing surgery (odds ratio 0.47, 95% confidence interval 0.25 to 0.90, p = 0.02) and the use of calcium channel blockers was associated with improved survival in patients with type B medically treated patients (odds ratio 0.55, 95% confidence interval 0.35 to 0.88, p = 0.01). In conclusion, the present study showed that use of β blockers was associated with improved outcome in all patients and in type A patients (overall as well as in those managed surgically). In contrast, use of calcium channel blockers was associated with improved survival selectively in those with type B (overall and in those treated medically). The use of angiotensin-converting enzyme inhibitors did not show association with mortality.
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleType-Selective Benefits of Medications in Treatment of Acute Aortic Dissection (from the International Registry of Acute Aortic Dissection [IRAD])
creatorSuzuki, Toru, MD ; Isselbacher, Eric M., MD ; Nienaber, Christoph A., MD ; Pyeritz, Reed E., MD ; Eagle, Kim A., MD ; Tsai, Thomas T., MD ; Cooper, Jeanna V., MS ; Januzzi, James L., MD ; Braverman, Alan C., MD ; Montgomery, Daniel G., BS ; Fattori, Rossella, MD ; Pape, Linda, MD ; Harris, Kevin M., MD ; Booher, Anna, MD ; Oh, Jae K., MD ; Peterson, Mark, MD ; Ramanath, Vijay S., MD ; Froehlich, James B., MD
creatorcontribSuzuki, Toru, MD ; Isselbacher, Eric M., MD ; Nienaber, Christoph A., MD ; Pyeritz, Reed E., MD ; Eagle, Kim A., MD ; Tsai, Thomas T., MD ; Cooper, Jeanna V., MS ; Januzzi, James L., MD ; Braverman, Alan C., MD ; Montgomery, Daniel G., BS ; Fattori, Rossella, MD ; Pape, Linda, MD ; Harris, Kevin M., MD ; Booher, Anna, MD ; Oh, Jae K., MD ; Peterson, Mark, MD ; Ramanath, Vijay S., MD ; Froehlich, James B., MD ; IRAD Investigators
descriptionThe effects of medications on the outcome of aortic dissection remain poorly understood. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with type B) with information on their medications at discharge and followed for ≤5 years were analyzed for the effects of the medications on mortality. The initial univariate analysis showed that use of β blockers was associated with improved survival in all patients (p = 0.03), in patients with type A overall (p = 0.02), and in patients with type A who received surgery (p = 0.006). The analysis also showed that use of calcium channel blockers was associated with improved survival in patients with type B overall (p = 0.02) and in patients with type B receiving medical management (p = 0.03). Multivariate models also showed that the use of β blockers was associated with improved survival in those with type A undergoing surgery (odds ratio 0.47, 95% confidence interval 0.25 to 0.90, p = 0.02) and the use of calcium channel blockers was associated with improved survival in patients with type B medically treated patients (odds ratio 0.55, 95% confidence interval 0.35 to 0.88, p = 0.01). In conclusion, the present study showed that use of β blockers was associated with improved outcome in all patients and in type A patients (overall as well as in those managed surgically). In contrast, use of calcium channel blockers was associated with improved survival selectively in those with type B (overall and in those treated medically). The use of angiotensin-converting enzyme inhibitors did not show association with mortality.
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0ISSN: 0002-9149
1EISSN: 1879-1913
2DOI: 10.1016/j.amjcard.2011.08.012
3PMID: 21944678
4CODEN: AJCDAG
languageeng
publisherNew York, NY: Elsevier Inc
subjectAbridged Index Medicus ; ACE inhibitors ; Acute Disease ; Adrenergic beta blockers ; Adrenergic beta-Antagonists - therapeutic use ; Aged ; Analysis ; Aneurysm, Dissecting - diagnosis ; Aneurysm, Dissecting - mortality ; Aneurysm, Dissecting - therapy ; Aortic Aneurysm, Thoracic - diagnosis ; Aortic Aneurysm, Thoracic - mortality ; Aortic Aneurysm, Thoracic - therapy ; aortic dissection ; Beta blockers ; Biological and medical sciences ; Blood and lymphatic vessels ; Calcium ; Calcium channel blockers ; Cardiology. Vascular system ; Cardiovascular ; Cause of Death - trends ; Diagnostic Imaging ; Diseases of the aorta ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Dissecting aneurysm ; Drug therapy ; Enzyme inhibitors ; Enzymes ; Female ; Follow-Up Studies ; Global Health ; Health aspects ; Humans ; Male ; Medical colleges ; Medical sciences ; Mortality ; Prognosis ; Retrospective Studies ; Surgery ; Survival analysis ; Survival Rate - trends ; Time Factors ; Treatment Outcome ; Vascular Surgical Procedures
ispartofThe American journal of cardiology, 2012, Vol.109 (1), p.122-127
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0Suzuki, Toru, MD
1Isselbacher, Eric M., MD
2Nienaber, Christoph A., MD
3Pyeritz, Reed E., MD
4Eagle, Kim A., MD
5Tsai, Thomas T., MD
6Cooper, Jeanna V., MS
7Januzzi, James L., MD
8Braverman, Alan C., MD
9Montgomery, Daniel G., BS
10Fattori, Rossella, MD
11Pape, Linda, MD
12Harris, Kevin M., MD
13Booher, Anna, MD
14Oh, Jae K., MD
15Peterson, Mark, MD
16Ramanath, Vijay S., MD
17Froehlich, James B., MD
18IRAD Investigators
title
0Type-Selective Benefits of Medications in Treatment of Acute Aortic Dissection (from the International Registry of Acute Aortic Dissection [IRAD])
1The American journal of cardiology
addtitleAm J Cardiol
descriptionThe effects of medications on the outcome of aortic dissection remain poorly understood. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with type B) with information on their medications at discharge and followed for ≤5 years were analyzed for the effects of the medications on mortality. The initial univariate analysis showed that use of β blockers was associated with improved survival in all patients (p = 0.03), in patients with type A overall (p = 0.02), and in patients with type A who received surgery (p = 0.006). The analysis also showed that use of calcium channel blockers was associated with improved survival in patients with type B overall (p = 0.02) and in patients with type B receiving medical management (p = 0.03). Multivariate models also showed that the use of β blockers was associated with improved survival in those with type A undergoing surgery (odds ratio 0.47, 95% confidence interval 0.25 to 0.90, p = 0.02) and the use of calcium channel blockers was associated with improved survival in patients with type B medically treated patients (odds ratio 0.55, 95% confidence interval 0.35 to 0.88, p = 0.01). In conclusion, the present study showed that use of β blockers was associated with improved outcome in all patients and in type A patients (overall as well as in those managed surgically). In contrast, use of calcium channel blockers was associated with improved survival selectively in those with type B (overall and in those treated medically). The use of angiotensin-converting enzyme inhibitors did not show association with mortality.
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0Abridged Index Medicus
1ACE inhibitors
2Acute Disease
3Adrenergic beta blockers
4Adrenergic beta-Antagonists - therapeutic use
5Aged
6Analysis
7Aneurysm, Dissecting - diagnosis
8Aneurysm, Dissecting - mortality
9Aneurysm, Dissecting - therapy
10Aortic Aneurysm, Thoracic - diagnosis
11Aortic Aneurysm, Thoracic - mortality
12Aortic Aneurysm, Thoracic - therapy
13aortic dissection
14Beta blockers
15Biological and medical sciences
16Blood and lymphatic vessels
17Calcium
18Calcium channel blockers
19Cardiology. Vascular system
20Cardiovascular
21Cause of Death - trends
22Diagnostic Imaging
23Diseases of the aorta
24Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
25Dissecting aneurysm
26Drug therapy
27Enzyme inhibitors
28Enzymes
29Female
30Follow-Up Studies
31Global Health
32Health aspects
33Humans
34Male
35Medical colleges
36Medical sciences
37Mortality
38Prognosis
39Retrospective Studies
40Surgery
41Survival analysis
42Survival Rate - trends
43Time Factors
44Treatment Outcome
45Vascular Surgical Procedures
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2Nienaber, Christoph A., MD
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4Eagle, Kim A., MD
5Tsai, Thomas T., MD
6Cooper, Jeanna V., MS
7Januzzi, James L., MD
8Braverman, Alan C., MD
9Montgomery, Daniel G., BS
10Fattori, Rossella, MD
11Pape, Linda, MD
12Harris, Kevin M., MD
13Booher, Anna, MD
14Oh, Jae K., MD
15Peterson, Mark, MD
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titleType-Selective Benefits of Medications in Treatment of Acute Aortic Dissection (from the International Registry of Acute Aortic Dissection [IRAD])
authorSuzuki, Toru, MD ; Isselbacher, Eric M., MD ; Nienaber, Christoph A., MD ; Pyeritz, Reed E., MD ; Eagle, Kim A., MD ; Tsai, Thomas T., MD ; Cooper, Jeanna V., MS ; Januzzi, James L., MD ; Braverman, Alan C., MD ; Montgomery, Daniel G., BS ; Fattori, Rossella, MD ; Pape, Linda, MD ; Harris, Kevin M., MD ; Booher, Anna, MD ; Oh, Jae K., MD ; Peterson, Mark, MD ; Ramanath, Vijay S., MD ; Froehlich, James B., MD
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0Abridged Index Medicus
1ACE inhibitors
2Acute Disease
3Adrenergic beta blockers
4Adrenergic beta-Antagonists - therapeutic use
5Aged
6Analysis
7Aneurysm, Dissecting - diagnosis
8Aneurysm, Dissecting - mortality
9Aneurysm, Dissecting - therapy
10Aortic Aneurysm, Thoracic - diagnosis
11Aortic Aneurysm, Thoracic - mortality
12Aortic Aneurysm, Thoracic - therapy
13aortic dissection
14Beta blockers
15Biological and medical sciences
16Blood and lymphatic vessels
17Calcium
18Calcium channel blockers
19Cardiology. Vascular system
20Cardiovascular
21Cause of Death - trends
22Diagnostic Imaging
23Diseases of the aorta
24Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
25Dissecting aneurysm
26Drug therapy
27Enzyme inhibitors
28Enzymes
29Female
30Follow-Up Studies
31Global Health
32Health aspects
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34Male
35Medical colleges
36Medical sciences
37Mortality
38Prognosis
39Retrospective Studies
40Surgery
41Survival analysis
42Survival Rate - trends
43Time Factors
44Treatment Outcome
45Vascular Surgical Procedures
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6Cooper, Jeanna V., MS
7Januzzi, James L., MD
8Braverman, Alan C., MD
9Montgomery, Daniel G., BS
10Fattori, Rossella, MD
11Pape, Linda, MD
12Harris, Kevin M., MD
13Booher, Anna, MD
14Oh, Jae K., MD
15Peterson, Mark, MD
16Ramanath, Vijay S., MD
17Froehlich, James B., MD
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1Isselbacher, Eric M., MD
2Nienaber, Christoph A., MD
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4Eagle, Kim A., MD
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6Cooper, Jeanna V., MS
7Januzzi, James L., MD
8Braverman, Alan C., MD
9Montgomery, Daniel G., BS
10Fattori, Rossella, MD
11Pape, Linda, MD
12Harris, Kevin M., MD
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14Oh, Jae K., MD
15Peterson, Mark, MD
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abstractThe effects of medications on the outcome of aortic dissection remain poorly understood. We sought to address this by analyzing the International Registry of Acute Aortic Dissection (IRAD) global registry database. A total of 1,301 patients with acute aortic dissection (722 with type A and 579 with type B) with information on their medications at discharge and followed for ≤5 years were analyzed for the effects of the medications on mortality. The initial univariate analysis showed that use of β blockers was associated with improved survival in all patients (p = 0.03), in patients with type A overall (p = 0.02), and in patients with type A who received surgery (p = 0.006). The analysis also showed that use of calcium channel blockers was associated with improved survival in patients with type B overall (p = 0.02) and in patients with type B receiving medical management (p = 0.03). Multivariate models also showed that the use of β blockers was associated with improved survival in those with type A undergoing surgery (odds ratio 0.47, 95% confidence interval 0.25 to 0.90, p = 0.02) and the use of calcium channel blockers was associated with improved survival in patients with type B medically treated patients (odds ratio 0.55, 95% confidence interval 0.35 to 0.88, p = 0.01). In conclusion, the present study showed that use of β blockers was associated with improved outcome in all patients and in type A patients (overall as well as in those managed surgically). In contrast, use of calcium channel blockers was associated with improved survival selectively in those with type B (overall and in those treated medically). The use of angiotensin-converting enzyme inhibitors did not show association with mortality.
copNew York, NY
pubElsevier Inc
pmid21944678
doi10.1016/j.amjcard.2011.08.012