Key result
Population-based incidences of acute type A and B aortic dissection were stable over time, though the overall autopsy rate declined from 25.2% in 2000–2004 to 16.1% in 2014–2016 (p=0.0001).
Why the study?
While the incidence of abdominal aortic aneurysm is falling, it was unclear whether population-based incidences of acute type A and B aortic dissection have changed over time.
Observational
No
Population-based incidences of acute type A and B aortic dissection remained stable over time in Sweden, though a decreasing autopsy rate has led to fewer cases diagnosed post-mortem.
Answers are grounded in this paper and cite their sources.
Stable Swedish incidences of acute aortic dissection despite declining autopsies support continued diagnostic vigilance; leaves open potential underdiagnosis.
Background. Aortic dissection (AD) and abdominal aortic aneurysm (AAA) share the same risk factors. Whereas the incidence of AAA is falling, it is unclear whether population-based incidences of acute type A and B AD have changed. The aim of this study was to investigate incidences of AD subtypes over time. Methods. Citizens in the municipality of Malmö, Sweden, diagnosed with AD in 2000–2004 and 2014–2016 were identified through the in-patient, clinical, and forensic autopsy registers. Results. The overall and gender-specific incidences of acute type A and B AD were stable over time. The overall autopsy rate declined from 25.2% in 2000–2004 to 16.1% in 2014–2016 (p = .0001) and patients with acute type A AD were more often encountered at autopsy (78% of cases) during the first time period, compared to 43% of cases during the second time period (p = .005), when the ratio of acute type A: acute type B AD was 2.6: 1. The proportion of individuals <65 years of age tended to be higher in acute type A AD compared to acute type B AD (p = .07). The frequencies of hypertension and smoking were 90% and 91%, respectively, in type A AD, and 86% and 86%, respectively in type B AD. Conclusions. Population-based incidences of acute type A and type B AD were stable over time, but the decreasing autopsy rate has led to a lower proportion of AD diagnosed at autopsy. Primary prevention towards hypertension and smoking seem necessary to reduce AD incidence.
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Acosta et al. (2019) conducted an observational in Acute type A and B aortic dissection. Time period 2014-2016 vs. Time period 2000-2004 was evaluated on Incidence of aortic dissection subtypes over time. Population-based incidences of acute type A and B aortic dissection were stable over time, though the overall autopsy rate declined from 25.2% in 2000–2004 to 16.1% in 2014–2016 (p=0.0001).
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