Epidemiology of Acute Type A Aortic Dissection
Pp. 3-29 (27)
Wen-Huang Li and Ping-Yen Liu
Acute type A aortic dissection (TAAAD) is a critical condition in patients
presenting with chest pain, but it seems relatively rarer than acute coronary syndrome.
The incidence of TAAAD is estimated at 2.0-4.04 per 100,000/year; about 22% of
patients with TAAAD die before being sent to a hospital. The mortality is high but is
different based on the location of the dissection. Many classifications systems, e.g., the
DeBakey, Stanford, Lansman, and European Working Group, have been developed to
classify the types of TAAAD. First, we define TAAAD and its two variants, intramural
hemorrhage (IMH) and penetrating atherosclerotic ulcer (PAU). Second, we introduce
the classification systems of TAAAD. Third, we show the incidence, prevalence, and
mortality of TAAAD and its variants. Fourth, we discuss the gender, age, and ethnic
differences in the presentations of TAAAD. In the last part of the chapter, we talk about
the incidence and mortality of TAAAD comorbid with some specific conditions,
diseases, and disorders, viz., aortic aneurysm, atherosclerosis, hypertension, diabetes,
pregnancy, trauma, substance abuse, Marfan, Loeys-Dietz syndrome, vascular type
Ehlers-Danlos syndrome, bicuspid aortic valve, and coarctation of the aorta.
Acute aortic dissection, Age distribution, Aortic diameter,
Chronobiology, Cocaine, DeBakey, Epidemiology, European Working Group
Classification, Gender difference, Genetic factors, Geography, Incidence,
Intramural hemorrhage, Lansman, Mortality, Penetrating atherosclerotic ulcer,
Prevalence, Risk factors, Stanford, Survival.
Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital and College of Medicine, 138 Sheng-Li Road, Tainan 704, Taiwan.