Research Article|Articles in Press

Impact of Antithrombotic Therapy on Clinical Outcomes in Patients with Type B Acute Aortic Syndrome

Open AccessPublished:March 10, 2023DOI:
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      Antithrombotic therapy has the potential to interfere with false lumen thrombosis. In type B acute aortic syndrome (AAS), the degree of false lumen thrombosis affects clinical outcomes. We aimed to assess the impact of antithrombotic therapy on the prognosis of patients with type B AAS.


      This single-center study included patients with type B AAS who were discharged alive. The primary outcome was aorta-related adverse events, defined as a composite of aorta-related death, aortic rupture, aortic repair, and progressive aortic dilation.


      Of the 406 patients, 64 patients (16%) were discharged with antithrombotic therapy and 342 (84%) without antithrombotic therapy. A total of 249 patients (61%) presented with intramural hematoma with complete thrombosis of the false lumen, and 157 (39%) presented with aortic dissection. During a median follow-up of 4.6 years, 32 patients (50%) in the antithrombotic group and 93 patients (27%) in the non-antithrombotic group had a primary outcome event. Cumulative incidence of aorta-related events at 1 and 3 years with death as the competing risk was higher in the antithrombotic group than the non-antithrombotic group (19 ± 5% vs. 9 ± 2% at 1 year and 40 ± 7% vs. 17 ± 2% at 3 years, P < 0.001).


      Antithrombotic therapy might be associated with an increased risk of aorta-related events in patients with type B AAS.

      Graphical abstract

      Key words

      Glossary of abbreviations:

      AAS (acute aortic syndrome), ACE (angiotensin-converting enzyme), AD (aortic dissection), ARB (angiotensin receptor blocker), CAD (coronary artery disease), CCB (calcium channel blocker), COPD (chronic obstructive pulmonary disease), IMH (intramural hematoma), PAD (peripheral artery disease), TEVAR (thoracic endovascular aortic repair)