Hashiyama Naoki, Goda Motohiko, Uchida Keiji, Isomatsu Yukihisa, Suzuki Shinichi, Mo Makoto, Nishida Takahiro, Masuda Munetaka
Department of Cardiovascular Surgery, Yokohama Minami-kyosai Hospital, Mutsuurahigashi 1-21-1, Kanazawa-ku, Yokohama, 236-0037, Japan.
Department of Cardiovascular Surgery, Yokohama City University Hospital, Fukuura 3-9, Kanazawaku, Yokohama, 236-0004, Japan.
J Cardiothorac Surg. 2018 Jun 27;13(1):80. doi: 10.1186/s13019-018-0765-y.
The relationship between aortic dissection and coronary artery disease is not clear. The purpose of this study was to clarify the difference in the rate of coronary artery atherosclerosis between Stanford type A and type B aortic dissection by reviewing our institutional database.
One hundred and forty-five patients (78 males, 67 females; mean age: 60 ± 12 years) admitted to our hospital with acute aortic dissection who underwent coronary angiography during hospitalization from 2000 through 2002 were enrolled in this study. The background characteristics, coronary risk factors, and coronary angiography findings (number of significant stenoses, stenoses according to Bogaty standards, extent index) of patients were compared between type A (Group A; n = 71) and type B dissection (Group B; N = 74).
Significantly more patients had prior histories of complications from ischemic heart disease in Group B than in Group A (P = 0.04), with no significant differences in comparison to other risk factors observed except for hypertension. Significantly (p = 0.005) more stenoses were observed in Group B (1.54 ± 0.04) than in Group A (0.38 ± 0.1). A significantly higher (P < 0.05) index score indicating the severity of coronary atherosclerosis was observed in Group B (1.49 ± 0.09) than in Group A (0.72 ± 0.07).
Stanford type B acute aortic dissection was significantly more frequently associated with coronary artery atherosclerosis than type A.
主动脉夹层与冠状动脉疾病之间的关系尚不清楚。本研究的目的是通过回顾我们机构的数据库，阐明斯坦福A型和B型主动脉夹层患者冠状动脉粥样硬化发生率的差异。
本研究纳入了2000年至2002年期间因急性主动脉夹层入住我院并在住院期间接受冠状动脉造影的145例患者（78例男性，67例女性；平均年龄：60±12岁）。比较了A型夹层组（A组；n = 71）和B型夹层组（B组；n = 74）患者的背景特征、冠状动脉危险因素和冠状动脉造影结果（严重狭窄数量、根据博加蒂标准的狭窄情况、范围指数）。
B组有缺血性心脏病并发症既往史的患者明显多于A组（P = 0.04），除高血压外，与其他危险因素相比无显著差异。B组（1.54±0.04）观察到的狭窄明显多于A组（0.38±0.1）（p = 0.005）。B组（1.49±0.09）冠状动脉粥样硬化严重程度的指数评分明显高于A组（0.72±0.07）（P < 0.05）。
斯坦福B型急性主动脉夹层比A型更常与冠状动脉粥样硬化相关。
