Cardiology Division, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Korean Circ J. 2012 Aug;42(8):528-37. doi: 10.4070/kcj.2012.42.8.528. Epub 2012 Aug 31.
Acute aortic syndrome (AAS) is a heterogeneous group of disorders that often present with severe chest or back pain. It includes acute aortic dissection (AD), intramural hematoma (IMH), dissecting aneurysm, and penetrating aortic ulcer (PAU). The clinical picture of AAS and its prognosis have not been studied in a large number of Korean patients. Therefore, we organized a multi-center registry to identify the clinical characteristics and treatment patterns, as well as long-term outcomes in Korean patients with AAS.
Five-hundred twenty-eight patients, who had been diagnosed with AAS, were enrolled into this registry from 10 centers. On a retrospective basis, we collected demographic, laboratory, imaging data, as well as follow-up clinical outcomes by reviewing medical records from individual centers. All the data were collected in core lab and analyzed in detail.
The mean patient age was 60.1±14.5 years; the male-to-female ratio was M : F=297 : 231. The prevalent risk factors for AAS included hypertension (361, 68.4%) and diabetes (52, 11.1%). The components of AAS that are included in this study are acute AD (446, 84.5%), IMH (57, 10.7%), and PAU (11, 2.1%). By type of AAS, patients diagnosed with Stanford A were 45.6% of enrolled patients, whereas those with Stanford B were 54.4% of enrolled patients. Among nearly half of the patients were treated with medicine (55.7%) alone, whereas 40.0% underwent surgery and 4.3% underwent endovascular treatment. Overall, the in-hospital event rate was 21.2% and the in-hospital death rate was 8.1%. The mean follow-up duration was 42.8 months and there showed 22.9% of total event and 10.1% of death during this period.
By organizing a multi-center registry of AAS, we could identify the characteristics of AAS in real-world Korean patients. Further, prospective study is warranted with a larger number of patients.
急性主动脉综合征（AAS）是一组异质性疾病，常表现为严重的胸痛或背痛。它包括急性主动脉夹层（AD）、壁内血肿（IMH）、夹层动脉瘤和穿透性主动脉溃疡（PAU）。AAS 的临床表现及其预后尚未在大量韩国患者中进行研究。因此，我们组织了一个多中心登记处，以确定韩国 AAS 患者的临床特征、治疗模式以及长期预后。
从 10 个中心共招募了 528 名诊断为 AAS 的患者入组该登记处。我们通过回顾各中心的病历，以回顾性方式收集了人口统计学、实验室、影像学数据以及随访临床结局。所有数据均在核心实验室收集并进行了详细分析。
患者的平均年龄为 60.1±14.5 岁；男女比例为 297:231。AAS 的主要危险因素包括高血压（361 例，68.4%）和糖尿病（52 例，11.1%）。本研究纳入的 AAS 包括急性 AD（446 例，84.5%）、IMH（57 例，10.7%）和 PAU（11 例，2.1%）。根据 AAS 类型，斯坦福 A 型患者占入组患者的 45.6%，斯坦福 B 型患者占 54.4%。近一半的患者（55.7%）单独接受药物治疗，40.0%接受手术治疗，4.3%接受血管内治疗。总的来说，院内事件发生率为 21.2%，院内死亡率为 8.1%。平均随访时间为 42.8 个月，在此期间总事件发生率为 22.9%，死亡率为 10.1%。
通过组织 AAS 的多中心登记处，我们可以确定韩国真实世界中 AAS 的特征。需要进行更大规模的前瞻性研究。
