The following is a summary of “Effect of Asymptomatic Common Carotid Artery Dissection on the Prognosis of Patients With Acute Type A Aortic Dissection,” published in the December 2023 issue of Cardiology by Jia et al.

This retrospective cohort study, spanning January 2015 to December 2017, investigated the impact of asymptomatic common carotid artery dissection (CCAD) without surgical intervention on the prognosis of 485 patients who underwent surgery for acute type A aortic dissection. Divided into two groups based on CCAD exposure, 111 patients (22.9%) had CCAD. Adjusting for baseline data, the group with CCAD exhibited significantly higher 30-day mortality (17.1% versus 6.0%, P<0.001) and fatal stroke incidence (7.7% versus 1.6%, P=0.001). Univariable and multivariable Cox regression analyses identified CCAD as an independent risk factor for 30-day mortality (hazard ratio [HR], 2.8 [95% CI, 1.5–5.2]; P=0.001). Over a median follow-up of 6.2 years, landmark analysis at 1 month postoperatively revealed a significant increase in mortality in the CCAD group, particularly within the first month (log-rank P=0.002), with no significant difference in survival after the initial month between the two groups (log-rank P=0.955). 

While asymptomatic CCAD heightened the risk of early fatal stroke and death in postoperative acute type A aortic dissection patients, it did not impact midterm survival in those who survived the early postoperative period. These findings shed light on the critical consideration of CCAD in the surgical management of acute type A aortic dissection, emphasizing the need for nuanced postoperative care strategies.

Source: ahajournals.org/doi/10.1161/JAHA.123.031542