Safety of anti-thrombotic therapy in acute aortic dissection; single center, observational study

Abstract

ABSTRACTBackgroundAcute aortic dissection occurs due to a primary tear in aortic intima, with blood from aortic lumen penetrating into diseased media, in which anti-thrombotic therapies may be harmful. We examined the prognosis in patients, who had already taken antithrombotic therapies at the onset of acute aortic dissection, and the safety to administer anti-thrombotic drugs in acute phase during hospitalization.Methods and ResultsWe retrospectively enrolled 685 patients with acute aortic dissection (type A/B: 454/231), who were transferred to Kurume University Hospital from 2004 to 2020. In both type A and B, there were no significant differences in in-hospital mortality between with and without antithrombotic therapies at the onset. Patients, who survived more than a day and administered anti-thrombotic drugs during hospitalization, had significantly lower in-hospital mortality than those who had no anti-thrombosis in acute phase in type A, while there was no significant difference in in-hospital mortality between the 2 groups in type B.ConclusionsWe demonstrated that anti-thrombotic drugs did not worsen the prognosis in patients with acute aortic dissection, indicating that we should not hesitate anti-thrombotic drugs if indicated.