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Figure 2.4. 30-day mortality in 464 patients from IRAD stratified by medical and surgical treatment in both type A and type B aortic dissection. Adapted from reference 3.

Figure 2.5. (A) Histogram of circadian variation in onset of acute aortic dissection showing total events per hour with superimposed best-fitting curve. (B) Histogram of seasonal variation in onset of aortic dissection showing total number of events each month with superimposed best-fitting curve. Adapted from reference 72.

Figure 2.5. (A) Histogram of circadian variation in onset of acute aortic dissection showing total events per hour with superimposed best-fitting curve. (B) Histogram of seasonal variation in onset of aortic dissection showing total number of events each month with superimposed best-fitting curve. Adapted from reference 72.

dent predictors of early mortality11'13'66. Chronic use of crack cocaine appears to predispose patients to acute aortic dissection, with preferred manifestation in the descending aorta70'71. Similar to acute myocardial infarction and other cardiovascular conditions' acute aortic dissection follows a chronobiological pattern and exhibits significant circadian and seasonal variations, with onset of dissection preferentially in the morning between 6 and 10 a.m. and in the early afternoon; moreover, the risk of dissection is higher in the cold season (winter and spring) than in the summer72 (Figure 2.5). These observations may have implications for tailoring treatment strategies, such as antihypertensive drugs, to vulnerable periods.

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