Aortic dissection prevalence is not one number — it changes dramatically by clinical setting, genetics, anatomy, sleep apnea, mental health burden, and referral selection. This review is worth reading because it maps where “rare disease” thinking fails and where targeted screening may reveal preventable high-risk phenotypes.
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Abstract: The aim of this review is to synthesize contemporary evidence regarding the prevalence of aortic dissection across diverse clinical settings and populations, while identifying key anatomical, genetic, and comorbid predictors associated with the condition. The review utilises 145 references. The mapped evidence indicates that aortic dissection prevalence is highly context-dependent, ranging from 0.3% in undifferentiated emergency chest-pain presentations to 10–25% in Marfan syndrome and up to 88.7% in selectively transferred suspected acute aortic syndrome cohorts. Recurrent signals across topics highlight a strikingly high burden of obstructive sleep apnea (61%–66.2%), post-traumatic stress disorder (21.4%–31.5%), and bovine aortic arch variation in dissection and broader thoracic aortopathy cohorts (15.6%–31.1%), alongside a consistent inverse association with diabetes mellitus. Heritable contribution emerged as a dominant theme, with familial factors accounting for an estimated 27.9% to 57% of liability and pathogenic variant yields reaching 51.5% in selected thoracic aortic aneurysm and dissection cohorts. Clinically, these patterns support integrating genetic evaluation, sleep assessment, and structured psychological screening into longitudinal management of dissection survivors, while flagging anatomical variants on routine imaging. The evidence remains heterogeneous in denominators and dominated by retrospective single-center cohorts, which limits certainty around true population-level burden. Future research should prioritize prospective multicenter registries with standardized prevalence reporting to clarify the diabetes paradox, the mechanistic role of obstructive sleep apnea in false-lumen behavior, and sex- and age-specific phenotypes that currently drive much of the observed heterogeneity.
Final search date and database lock: 2026-04-26 22:40:44 CEST
Plan: Pro (expanded craft tokens; source: PubMed)
Source: PubMed
Total Abstracts/Papers: 670
Downloaded Abstracts/Papers: 670
Included original and non-original Abstracts/Papers (all): 423
Included original Abstracts/Papers (Vote counting by direction of effect): 366
Reference Index (links used in paper): 145
Total participants (topic deduplicated ΣN): 3728233
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[216] Obstructive Sleep Apnoea in Stanford Type B Aortic Dissection Is Associated With Multiple Imaging Signs Related to Late Aortic Events. — https://doi.org/10.3389/fcvm.2021.752763
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[249] Morbid obesity impacts mortality among inpatients with type a aortic dissection: an analysis of the national inpatient sample. — https://doi.org/10.1186/s13019-022-02080-6
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[252] Cardiovascular anomalies in Turner syndrome: spectrum, prevalence, and cardiac MRI findings in a pediatric and young adult population. — https://doi.org/10.2214/ajr.10.4973
[253] Long-Term Outcomes of Endovascular Treatment for Type B Aortic Dissection with Simple Renal Cysts: A Multicenter Retrospective Study. — https://doi.org/10.31083/j.rcm2307226
[254] Targeted genetic analysis in a cohort of sporadic death from spontaneous rupture of thoracic aortic dissection in Han Chinese population. — https://doi.org/10.1016/j.fsigen.2024.103051
[256] Sex Differences in the Characteristics of Acute Aortic Dissection: Stanford Type A Dissection among Elderly Women in Japan. — https://doi.org/10.14789/ejmj.jmj25-0006-oa
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[267] Obesity Increases In-Hospital Mortality of Acute Type A Aortic Dissection Patients Undergoing Open Surgical Repair: A Retrospective Study in the Chinese Population. — https://doi.org/10.3389/fcvm.2022.899050
[269] Risk of aortic root or ascending aorta complications in patients with bicuspid aortic valve with and without coarctation of the aorta. — https://doi.org/10.1016/j.amjcard.2009.05.045
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[309] Presence of simple renal cysts is associated with increased risk of aortic dissection: a common manifestation of connective tissue degeneration? — https://doi.org/10.1136/hrt.2010.205328
[351] Associations of Age and Sex With Marfan Phenotype: The National Heart, Lung, and Blood Institute GenTAC (Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions) Registry. — https://doi.org/10.1161/circgenetics.116.001647
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[368] Comparative analysis of postoperative sexual dysfunction and quality of life in type a aortic dissection patients of different ages. — https://doi.org/10.1186/s13019-021-01468-0
[374] Risk factors and clinical outcomes of severe postoperative hypoxaemia following surgical repair of Stanford type A aortic dissection: a retrospective cohort study. — https://doi.org/10.3389/fmed.2025.1603262
[377] Frequency and Detection of Stanford Type A Aortic Dissection in Hyperacute Stroke Management. — https://doi.org/10.1159/000445528
[392] Risk factors for acute kidney injury and its impact on 3-year mortality after thoracic endovascular repair for type B aortic dissection. — https://doi.org/10.3389/fcvm.2025.1691995
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