Abstract 13986: Beta-blocker Therapy Reduces Adverse Aorta-Related Events in Patients With Type B Acute Aortic Intramural Hematoma

Abstract

Background: Optimal medical therapy is widely accepted as a first line therapy for patients with type B acute aortic intramural hematoma (B-IMH). Beta-blocker therapy is supposed to be effective for prevention of aortic dilatation by decreasing aortic wall stress. However, benefits of beta-blocker therapy have not been rigorously shown in B-IMH compared with type B acute aortic dissection with patent false lumen. The purpose of this study was to assess the association of beta-blocker therapy and clinical outcomes in B-IMH patients. Methods and Results: A total of 193 consecutive acute B-IMH patients admitted to our hospital and discharged alive were retrospectively analyzed. The mean age was 71±10 years and 124 (64%) patients were men. Of the 193 patients, 165 patients (85%) were treated with beta-blocker therapy at discharge. We compared the incidence of aorta-related adverse events, a composite of end-organ or limb ischemia, aortic rupture, recurrent dissection, aortic expansion ≥5 mm, and aortic surgery, between the patients with and without beta-blocker therapy. During a mean follow up of 4.2years, 16 of 165 (9.7%) patients with beta-blocker therapy developed aorta-related adverse events, whereas 8 of 28 (29%) patients without beta-blocker therapy developed aorta-related adverse events (p<0.001). A multivariate Cox regression analysis adjusted for age, gender and prevalence of hypertension indicated that beta-blocker therapy was associated with a significantly reduced risk for aorta-related adverse events (hazard ratio=0.33, 95% confidence interval: 0.14-0.83, p=0.02). Conclusions: Beta-blocker therapy was associated with a significantly reduced risk for aorta-related adverse events in patients with type B acute aortic intramural hematoma.