title: Angiotensin-converting enzyme inhibitors reduce long-term aortic events in patients with acute type B aortic dissection.
abstract: BACKGROUND
  Medical therapy gives excellent short-term outcomes for patients with Stanford type B acute aortic dissection. However, the affected aorta is often compromised by aneurysmal dilatation and rupture, resulting in poor long-term outcome. The present study investigated which antihypertensive treatment may prevent long-term aortic events in these patients.
  
  
  RESULTS
  The study group comprised 78 consecutive patients with Stanford type B acute aortic dissection who were treated medically and followed-up for an average of 873+/-548 days. The optimal hypertensive drug regimen to reduce aortic events was determined by multivariate analyses. Of the 78 patients, 73 (94%) were discharged from hospital with medical therapy, and aortic events occurred in 13 (18%) of them (aortic rupture/recurrent dissection in 2 (3%); aortic expansion >or=60 mm in 7 (10%), rapid aortic expansion >or=10 mm/year in 3 (4%), and development of visceral/limb ischemia in 1 (1%)) during follow-up. By multivariate analysis, patients given angiotensin-converting enzyme inhibitor (ACEI) were less likely to have long-term aortic events than those without (odds ratio: 0.18, 95% confidence interval: 0.04-0.85).
  
  
  CONCLUSIONS
  Use of ACEI is associated with a reduced risk of long-term aortic events in patients with medically treated type B aortic dissection.
authors.affiliation: Department of Cardiology, National Cardiovascular Center, Suita, Japan. stake@muse.ocn.ne.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takeshita
authors.forename: Shingo
authors.initials: S
authors.lastname: Sakamoto
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kitada
authors.forename: Koichi
authors.initials: K
authors.lastname: Akutsu
authors.forename: Hideki
authors.initials: H
authors.lastname: Hashimoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D001019:Aortic Rupture / Q000401:mortality* / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors