CC BY 4.0 · Aorta (Stamford) 2023; 11(05): 1-18
DOI: 10.1055/s-0044-1787942
IMAD 2024 Meeting Abstracts

Risk of Aortic Dissection Type A and B in Non-Syndromic Users of Beta-Blockers: A Nationwide Danish Population-based Nested Case-control and Historical Cohort Study

Mads Liisberg
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Odense, Odense, Denmark
2   Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
3   Department of Clinical Research, University of Southern Denmark, Odense, Denmark
,
Jes S. Lindholt
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Odense, Odense, Denmark
2   Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
,
Katrine L. Larsen
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Odense, Odense, Denmark
2   Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
3   Department of Clinical Research, University of Southern Denmark, Odense, Denmark
,
Axel CP. Diederichsen
2   Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
4   Department of Cardiology, Odense University Hospital, Odense, Denmark
,
Jesper Hallas
5   Department of Public Health, Odense University Hospital; and the Research Unit of Clinical Pharmacology and Pharmacy, University of Southern Denmark, Odense, Denmark
,
Anne N. Lasota
6   Department of Vascular Surgery, Aalborg University Hospital, Aalborg, Denmark
,
Henrik K. Jensen
7   Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
8   Department of Clinical Medicine, Aarhus University, Health, Aarhus, Denmark
,
Leila L. Benhassen
8   Department of Clinical Medicine, Aarhus University, Health, Aarhus, Denmark
9   Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
,
Amalie L. Mørkved
8   Department of Clinical Medicine, Aarhus University, Health, Aarhus, Denmark
9   Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
,
Reshaabi Srinanthalogen
9   Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
,
Henning Bundgaard
10   Department of Cardiology, The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
,
Joachim SS. Kristensen
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Odense, Odense, Denmark
2   Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
3   Department of Clinical Research, University of Southern Denmark, Odense, Denmark
,
Lasse M. Obel
1   Department of Cardiothoracic and Vascular Surgery, University Hospital Odense, Odense, Denmark
2   Elite Research Centre of Individualized Medicine in Arterial Disease (CIMA), Odense University Hospital, Odense, Denmark
3   Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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    Background: Despite lack of evidence, guidelines recommend beta-blockers (BB) as first-choice antihypertensive treatment in patients with aortic dissection (AD) type A and B. In this observational study, we estimated the risk of onset of AD in long-term BB users and the mortality in AD survivors between patients treated with and without BB.

    Methods: This nationwide, population-based, combined case-control and historical cohort study included all hospitalized adult patients in Denmark with a validated diagnosis of AD from 1996 through 2016. Patients with bicuspid aortic valves, Marfan syndrome, and Ehlers-Danlos syndrome were excluded. Data was merged between nationwide healthcare registries including the National Prescription Registry.

    For the case-control study, AD cases were matched 1:10(±1) on age, sex, date, and cumulative antihypertensive drug use with patients from the general Danish population treated for hypertension (HT-controls). Long-term BB usage was defined as subscription of ≥2,000 Defined Daily Doses (DDD). In sensitivity analyses, doseresponse associations were evaluated with different DDD thresholds.

    Results: Of 5,018 registered cases, 3,017 (60.1%) were verified as AD. After exclusions and matching with HT-controls, the nested case-control study consisted of 1,657 cases and 16,139 HT-controls, and the historical cohort study of 2,161 AD survivors. The adjusted odds ratios for onset of AD type A and B in long-term BB users compared to HT-controls were 1.7 (95% CI: 1.3-2.3) and 3.7 (95% CI: 2.7-5.2), respectively. An increasing dose-response association was observed for AD type B.

    Conclusion: The risk of AD increased significantly in long-term-BB users, especially for AD type B. Though these results require further studies, preferably randomized clinical trials to confirm our findings.


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    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    11 June 2024

    © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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