Twenty-five years of observations from the International Registry of Acute Aortic Dissection (IRAD) and its impact on the cardiovascular scientific community

Santi Trimarchi; Tim J Mandigers; Daniele Bissacco; Christoph Nienaber; Eric M Isselbacher; Arturo Evangelista; Toru Suzuki; Eduardo Bossone; Linda A Pape; James L Januzzi; Kevin M Harris; Patrick T O'Gara; Dan Gilon; Stuart Hutchison; Himanshu J Patel; Elise M Woznicki; Daniel Montgomery; Eva Kline-Rogers; Kim A Eagle

doi:10.1016/j.jtcvs.2023.06.021

Twenty-five years of observations from the International Registry of Acute Aortic Dissection (IRAD) and its impact on the cardiovascular scientific community

J Thorac Cardiovasc Surg. 2023 Jul 13:S0022-5223(23)00608-6. doi: 10.1016/j.jtcvs.2023.06.021. Online ahead of print.

Authors

Santi Trimarchi¹, Tim J Mandigers², Daniele Bissacco³, Christoph Nienaber⁴, Eric M Isselbacher⁵, Arturo Evangelista⁶, Toru Suzuki⁷, Eduardo Bossone⁸, Linda A Pape⁹, James L Januzzi¹⁰, Kevin M Harris¹¹, Patrick T O'Gara¹², Dan Gilon¹³, Stuart Hutchison¹⁴, Himanshu J Patel¹⁵, Elise M Woznicki¹⁶, Daniel Montgomery¹⁶, Eva Kline-Rogers¹⁶, Kim A Eagle¹⁶

Affiliations

¹ Section of Vascular Surgery, Cardio Thoracic Vascular Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy. Electronic address: santi.trimarchi@unimi.it.
² Section of Vascular Surgery, Cardio Thoracic Vascular Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
³ Section of Vascular Surgery, Cardio Thoracic Vascular Department, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁴ Department of Cardiology, Cardiology and Aortic Centre, The Royal Brompton & Harefield NHS Trust, Imperial College, London, United Kingdom.
⁵ Cardiology Department, Thoracic Aortic Center, Massachusetts General Hospital, Boston, Mass.
⁶ Cardiology Department, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
⁷ Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom.
⁸ Cardiology Division, Cardarelli Hospital, Naples, Italy.
⁹ Department of Medicine, University of Massachusetts Hospital, Worcester, Mass.
¹⁰ Cardiometabolic Trials, Baim Institute for Clinical Research, Boston, Mass; Cardiology Division, Massachusetts General Hospital, Boston, Mass.
¹¹ Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minn.
¹² Department of Cardiology, Brigham & Women's Hospital, Boston, Mass.
¹³ Department of Non-invasive Cardiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
¹⁴ Department of Cardiac Sciences, University of Calgary Medical Centre, Calgary, Canada.
¹⁵ Department of Cardiac Surgery, University of Michigan, Ann Arbor, Mich.
¹⁶ Cardiovascular Center, University of Michigan, Ann Arbor, Mich.

PMID: 37453718
DOI: 10.1016/j.jtcvs.2023.06.021

Abstract

Objective: The International Registry of Acute Aortic Dissection (IRAD) celebrated its 25th anniversary in January 2021. This study evaluated IRAD's role in promoting the understanding and management of acute aortic dissection (AD) over these years.

Methods: IRAD studies were identified, analyzed, and ranked according to their citations per year (c/y) to determine the most-cited IRAD studies and topics. A systematic search of the literature identified cardiovascular guidelines on the diagnosis and management of acute AD. Consequently, IRAD's presence and impact were quantified using these documents.

Results: Ninety-seven IRAD studies were identified, of which 82 obtained more than 10 cumulative citations. The median c/y index was 7.33 (25th-75th percentile, 4.01-16.65). Forty-two studies had a greater than median c/y index and were considered most impactful. Of these studies, most investigated both type A and type B AD (n = 17, 40.5%) and short-term outcomes (n = 26, 61.9%). Nineteen guideline documents were identified from 26 cardiovascular societies located in Northern America, Europe, and Japan. Sixty-nine IRAD studies were cited by these guidelines, including 38 of the 42 most-impactful IRAD studies. Among them, partial thrombosis of the false lumen as a predictor of postdischarge mortality and aortic diameters as a predictor of type A occurrence were determined as most-impactful specific IRAD topics by their c/y index.

Conclusions: IRAD has had and continues to have an important role in providing observations, credible knowledge, and research questions to improve the outcomes of patients with acute AD.

Keywords: IRAD; International Registry of Acute Aortic Dissection; acute aortic dissection; cardiovascular societies; clinical practice guidelines.