Abstract 13660: The Decline of Beta Blocker Usage in Patients Admitted With Acute Type A Aortic Dissection

• Published in: Circulation (New York, N.Y.) N.Y.), 2019-11, Vol.140 (Suppl_1 Suppl 1), p.A13660-A13660
• Main Authors: Ashur, Carmel, Breeden, Madison, Farhat, Linda, Norton, Elizabeth, Froehlich, James B, Kim, Karen, Fukuhara, Shinichi, Deeb, Michael G, Patel, Himanshu J, Eagle, Kim, Yang, Bo, Hofmann Bowman, Marion A
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.13660

IntroductionBeta blockers are the recommended treatment for patients with thoracic aortic aneurysm and the preferred treatment drug in patients with hypertension and aortic disease. We queried whether patients diagnosed with acute type A aortic dissection (ATAAD) are being treated with beta blockers as recommended by current guidelines.MethodsWe used a subset cohort of all patients (n=674) from a large referral area who presented to the University of Michigan with an ATAAD between July 1996 and April 2018. We specifically looked at patients presenting after January 2014 (n=188), as this was when the intake questionnaire included a section on beta blocker usage within the past two weeks, and compared against patients presenting January 2006-December 2007 (n=78) using manual chart review. Society of Thoracic Surgeons data elements from the University of Michigan Cardiac Surgery Data Warehouse were obtained to identify the cohort and determine pre-operative characteristics. We compared cumulative and annual percentages of patients with a beta blocker as a home medication upon presentation, and then compared patient characteristics and demographics between these two groups.ResultOf patients presenting with an ATAAD after January 2014, only 20.2% patients had a beta blocker listed as a home medication, which is significantly lower than the 32.0% of patients presenting between 2006 and 2007 (p=0.04). There was a downward trend from 2006 to 2018, with an R-squared value of 0.72. Among beta blocker users, there were significantly more patients with history of prior MI (p=0.015), prior cardiovascular intervention (p=0.001) as well as hypertension (p=0.005).ConclusionWe found that only 20.21% of patients presenting with an ATAAD after 2014 have a beta blocker listed as a home medication, with a significant downward trend compared to 2006 and 2007. Future research is needed to validate these results in a larger cohort in order to better understand reasons why beta blockers are increasingly falling out of favor.