Acute type B aortic dissection is a cardiovascular emergency with considerable mortality and morbidity risk. Male-female differences have been observed in cardiovascular disease; however, literature on type B aortic dissection is scarce.
A retrospective cohort study was conducted including all consecutive patients with acute type B aortic dissection between 2007 and 2017 in 4 tertiary hospitals using patient files and questionnaires for late morbidity. In total, 384 patients were included with a follow-up of 6.1 (range, 0.02-14.8) years, of which 41% (n=156) were female. Women presented at an older age than men (67 [interquartile range (IQR), 57-73] versus 62 [IQR, 52-71]; =0.015). Prior abdominal aortic aneurysm (6% versus 15%; =0.009), distally extending dissections (71 versus 85%; =0.001), and clinical malperfusion (18% versus 32%; =0.002) were less frequently observed in women. Absolute maximal descending aortic diameters were smaller in women (36 [IQR: 33-40] mm versus 39 [IQR, 36-43] mm; <0.001), while indexed for body surface area diameters were larger in women (20 [IQR, 18-23] mm/m versus 19 [IQR, 17-21] mm/m). No male-female differences were found in treatment choice; however, indications for invasive treatment were different (<0.001). Early mortality rate was 9.6% in women and 11.8% in men (=0.60). The 5-year survival was 83% (95% CI, 77-89) for women and 84% (95% CI, 79-89) for men (=0.90). No male-female differences were observed in late (re)interventions.
No male-female differences were found in management, early or late death, and morbidity in patients presenting with acute type B aortic dissection, despite distinct clinical profiles at presentation. More details on the impact of age and type of intervention are warranted in future studies.