title: Screening and management for ischemic heart disease in patients undergoing emergency surgery for a type A acute aortic dissection.
abstract: OBJECTIVE
  We assessed the incidence of coronary artery disease (CAD) during hospitalization after emergency surgery for a type A acute aortic dissection.
  
  
  METHODS
  A total of 123 patients underwent multi-slice computed tomography (MSCT) scans during an early stage after surgery. The patients were divided into two groups: group I consisted of 14 patients (11.4%) who had coronary artery stenosis of more than 75% on MSCT, and group II consisted of 109 patients (88.6%) who had no coronary lesions.
  
  
  RESULTS
  The prevalence of diabetes, dyslipidemia and a smoking history was significantly higher in group I. Although the serum low-density lipoprotein cholesterol levels were similar, the high-density lipoprotein cholesterol (HDL) level was significantly lower in group I (36.4 ± 7.9 mg/dl) than in group II (49.6 ± 13.5 mg/dl, P = 0.0005). The maximum carotid intima-media thickness (IMT) was significantly thicker in group I (1.17 ± 0.37 mm) compared to group II (0.96 ± 0.33 mm, P = 0.0297). The logistic regression analysis detected that a carotid IMT over 1.1 mm (odds ratio 4.35, P = 0.0371) and HDL less than 40 mg/dl (odds ratio 3.90, P = 0.0482) were predictors for CAD.
  
  
  CONCLUSIONS
  CAD screening should be recommended for patients with aortic dissection who have several atherosclerosis risk factors, even after emergency surgery.
authors.affiliation: Department of Cardiovascular Surgery, Nihon University School of Medicine, 30-1 Oyaguchi Kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan, cvshata@aol.com.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hata
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hata
authors.forename: Akira
authors.initials: A
authors.lastname: Sezai
authors.forename: Kenji
authors.initials: K
authors.lastname: Akiyama
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Orime
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakui
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001026:Coronary Artery Bypass; D023921:Coronary Stenosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D004630:Emergencies; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011237:Predictive Value of Tests; D012307:Risk Factors