Cocaine-related aortic dissection: Lessons from the international registry of acute aortic dissection

Joshua H. Dean, Elise M. Woznicki, Patrick O'Gara, Daniel G. Montgomery, Santi Trimarchi, Truls Myrmel, Reed E. Pyeritz, Kevin M. Harris, Toru Suzuki, Alan C. Braverman, G. Chad Hughes, Eva Kline-Rogers, Christoph A. Nienaber, Eric M. Isselbacher, Kim A. Eagle, Eduardo Bossone

Research output: Contribution to journalArticlepeer-review


Background Acute aortic dissection associated with cocaine use is rare and has been reported predominantly as single cases or in small patient cohorts.

Methods Our study analyzed 3584 patients enrolled in the International Registry of Acute Aortic Dissection from 1996 to 2012. We divided the population on the basis of documented cocaine use (C+) versus noncocaine use (C-) and further stratified the cohorts into type A (33 C+/2332, 1.4%) and type B (30 C+/1252, 2.4%) dissection.

Results C+ patients presented at a younger age and were more likely to be male and black. Type B dissections were more common among C+ patients than in C- patients. Cocaine-related acute aortic dissection was reported more often at US sites than at European sites (86.4%, 51/63 vs 13.6%, 8/63; P

Conclusions Cocaine use is implicated in 1.8% of patients with acute aortic dissection. The typical patient is relatively young and has the additional risk factors of hypertension and tobacco use. In-hospital mortality for those with cocaine-related type A dissection is lower than for those with noncocaine-related dissection, likely due to the younger age at presentation.

Original languageEnglish
Pages (from-to)878-885
Number of pages8
JournalAmerican Journal of Medicine
Issue number9
Publication statusPublished - Sep 1 2014


  • Acute aortic dissection
  • Cocaine
  • Outcomes

ASJC Scopus subject areas

  • Medicine(all)


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