title: Acute aortic dissection in blacks: insights from the International Registry of Acute Aortic Dissection.
abstract: BACKGROUND
  Few data exist on race-related differences in acute aortic dissection patients.
  
  
  METHODS
  We evaluated black (n = 189, 14%) or white (n = 1165, 86%) patients (mean age 62.8 ± 15.3 years; 36.4% women) enrolled in 13 US centers participating in the International Registry of Acute Aortic Dissection. We excluded patients of other racial descent.
  
  
  RESULTS
  Type B acute aortic dissection was more frequent in the black cohort (52.4% vs 39.3%, P = .001). Black patients were younger (mean age 54.6 ± 12.8 years vs 64.2 ± 15.2 years, P <.001) and more likely to have a history of cocaine abuse (12% vs 1.6%, P <.001), hypertension (89.7% vs 73.9%, P <.001), and diabetes (13.2% vs 6.4%, P = .001). Conversely, they were less likely to have bicuspid aortic valve (1.8% vs 5.8%, P = .029), iatrogenic dissection (0.5% vs 4.5%, P = .010), and prior aortic dissection repair (7.7% vs 12.8%, P = .047). Presenting features were similar except for more abdominal pain (44.6% vs 30.6%, P <.001) and left ventricular hypertrophy on echocardiogram (44.2% vs 20.1%, P <.001) in blacks. Management was similar. Hypotension/shock/tamponade was less common (7.6% vs 20.1%, P <.001), whereas acute kidney failure was more common (41.0% vs 21.7%, P <.001) in blacks. Mortality was similar in-hospital (14.3% vs 19.1%, P = .110, odds ratio 0.704, 95% confidence interval 0.457-1.085) and at 3 years postdischarge, as evaluated by Kaplan-Meier survival analysis (22.0% vs 14.3%, P = .224, SE = 0.062 and 0.018).
  
  
  CONCLUSIONS
  Our study shows differences in type, etiology, and presentation of blacks and whites with acute aortic dissection, yet similar mortality for these cohorts.
authors: Heart Department, University Hospital, Salerno, Italy. Electronic address: ebossone@hotmail.com.
authors: Eduardo
authors: E
authors: Bossone
authors: Reed E
authors: RE
authors: Pyeritz
authors: Patrick
authors: P
authors: O'Gara
authors: Kevin M
authors: KM
authors: Harris
authors: Alan C
authors: AC
authors: Braverman
authors: Linda
authors: L
authors: Pape
authors: Mark J
authors: MJ
authors: Russo
authors: G Chad
authors: GC
authors: Hughes
authors: Thomas T
authors: TT
authors: Tsai
authors: Daniel G
authors: DG
authors: Montgomery
authors: Christoph A
authors: CA
authors: Nienaber
authors: Eric M
authors: EM
authors: Isselbacher
authors: Kim A
authors: KA
authors: Eagle
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000208:ethnology* / Q000209:etiology / Q000401:mortality; D001014:Aortic Aneurysm / Q000150:complications / Q000208:ethnology*; D044383:Black People; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012042:Registries; D016896:Treatment Outcome; D014481:United States; D044465:White People; D001741:Black or African American
keywords: Aorta; Epidemiology; Mortality