Gender variations in acute aortic dissection: insights from a retrospective cohort analysis

Objectives: Aortic dissection is a life-threatening cardiovascular condition, and this study aims to explore gender-related differences in clinical characteristics, treatment outcomes, and complications. Methods: We conducted a retrospective cohort study analyzing medical records of 74 patients diagnosed with symptomatic aortic aneurysms at Afshar and Shahid Sadoughi Hospitals in Yazd from 2017 to 2023. We categorized patients by gender and collected the data on demographics, clinical presentations, comorbidities, treatment strategies, complications, and mortality. Results: The study included 54 males and 20 females. Females were older at presentation (mean age 64.3 years) and had a higher prevalence of diabetes mellitus (45.0% vs. 14.8%, P=0.011). The time from symptom onset to admission was significantly longer for females (4.0 vs. 2.4 hours, P=0.039). Treatment strategies were similar across sexes. Complication rates, such as heart failure and cardiac tamponade, were higher in females (P=0.057), although overall mortality rates were similar (37.0% in males vs. 45.0% in females, P=0.933). Cox regression analysis showed age as a significant risk factor for mortality (HR 1.03, 95% CI 1.01-1.05, P=0.003). Conclusions: Clinical presentations and treatment approaches for aortic dissection are generally similar between sexes, but differences in age at presentation and comorbidities are noteworthy. These findings underscore the importance of considering sex-specific factors in the management and prognosis of aortic dissection to improve patient outcomes