Sex Differences in Trends in Incidence of Thoracic Aortic Aneurysm Repair and Aortic Dissection: 2005-2015

Côté, Claudia L.; Waard, Dominique de; Kivell, Matthew; Fagan, Andrew; Horne, Gabrielle; Hassan, Ansar; Hajizadeh, Mohammad; Herman, Christine

doi:10.1016/j.cjco.2022.08.012

Cited by 9 publications

(3 citation statements)

References 33 publications

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“…Almost two-thirds of patients in our cohort undergoing aortic arch replacement were male. This is in line with other studies investigating aortic [9][10][11] and non-aortic cardiac surgery [3,4], all reporting a predominance of male patients. It is generally assumed that the female hormone estrogen has a protective effect on cardiovascular health but it lessens after menopause [12].…”

Section: Discussionsupporting

confidence: 92%

“…It is generally assumed that the female hormone estrogen has a protective effect on cardiovascular health but it lessens after menopause [12]. This is probably why females tend to develop cardiovascular disease at a later date and are therefore older than men, not only in our cohort, but in most studies addressing cardiac and aortic surgery [3,4,[9][10][11]. We also observed that male patients had a significantly higher incidence of coronary artery disease and renal impairment, indicating a higher burden of arteriosclerosis.…”

Section: Discussionmentioning

confidence: 52%

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Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement

Benk,

Berger,

Kondov

et al. 2023

JCM

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Background: Our aim was to investigate outcomes and long-term survival in male and female patients after frozen elephant trunk (FET) total arch replacement. Methods: Between March 2013 and January 2023, 362 patients underwent aortic arch replacement via the FET technique. We compared patient characteristics and intra- and postoperative data between male and female patients. Results: Male patients were significantly younger (p = 0.012) but revealed a higher incidence of coronary artery disease (p = 0.008) and preoperative dialysis (p = 0.017). More male patients presented with type A aortic dissections (p = 0.042) while more female patients had aortic aneurysms (p = 0.025). The aortic root was replaced in significantly more male patients (p = 0.013), resulting in significantly longer cardiopulmonary bypass duration (p < 0.001) and operative times (p < 0.001). There were no statistically significant differences in postoperative outcome parameters including in-hospital mortality (p = 0.346). However, new in-stent thrombus formation was significantly more frequent in female patients (p = 0.002). Age in years (odds ratio (OR): 1.026, p = 0.049), an acute pathology (OR: 1.941, p = 0.031) and preoperative dialyses (OR: 3.499, p = 0.010) were predictive for long-term mortality in our Cox regression model, sex (p = 0.466) was not. There was no statistical difference in overall survival (log rank: p = 0.425). Conclusions: Female patients are older but reveal fewer cardiovascular risk factors; aneurysms are more common in female than male patients. As female patients undergo concomitant surgical procedures less often, their operative times are shorter. While survival and outcomes were similar, female patients suffered from postoperative new in-stent thrombus formation significantly more often.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 52%

Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement

Benk,

Berger,

Kondov

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…Two recent meta-analyses also report no differences in postoperative mortality between male and female ATAAD patients [19 ▪▪ ,59 ▪▪ ]. Two single center studies also report no differences [60,62 ▪ ] Mid-term all-cause mortality in ATAAD patients treated operatively also shows no sex differences at 3 and 5 years postevent [56,60]. However, female sex was found to be protective against mortality at 10 years in a Canadian cohort, which could indicate better long-term outcomes in women who survive the incident event and are treated operatively [61 ▪ ].…”

Section: Discussionmentioning

confidence: 95%

Gender differences in acute aortic syndromes

Bhatt

Chung

2023

Current Opinion in Cardiology

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Purpose of reviewAcute aortic syndromes include acute aortic dissection, intramural hematoma, and penetrating aortic ulcer, and are associated with high mortality and morbidity. This review focuses on recent findings and current understanding of gender-related and sex-related differences in acute aortic syndromes. Recent findingsLarge international and national registries, population studies, and multicentre national prospective cohort studies show evidence of sex differences in acute aortic syndromes. Recent studies of risk factors, aorta remodelling, and genetics provide possible biological basis for sex differences. The 2022 American College of Cardiology/American Heart Association Guidelines for the Diagnosis and Management of Aortic Disease revise recommendations for surgical management for aortic root and ascending aorta dilatation, which could impact outcome differences between the sexes.

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Aortic Pathology and Peripheral Arterial Disease in Women

Teraa,

Hazenberg

2024

Manual of Cardiovascular Disease in Women

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Sex Differences in Trends in Incidence of Thoracic Aortic Aneurysm Repair and Aortic Dissection: 2005-2015

Cited by 9 publications

References 33 publications

Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement

Comparative Study of Male and Female Patients Undergoing Frozen Elephant Trunk Total Arch Replacement

Gender differences in acute aortic syndromes

Aortic Pathology and Peripheral Arterial Disease in Women

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