The impact of sex and gender on aortic events in patients with Marfan syndrome

• Published in: European journal of cardio-thoracic surgery Vol. 62; no. 5
• Main Authors: Nucera, Maria, Heinisch, Paul P, Langhammer, Bettina, Jungi, Silvan, Mihalj, Maks, Schober, Patrick, Luedi, Markus M, Yildiz, Murat, Schoenhoff, Florian S
• Format: Journal Article
• Language: English
• Published: Germany 04.10.2022
• Subjects: childbirth; sex and gender; aortic aneurysm; aortic dissection; Marfan syndrome
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1093/ejcts/ezac305

Aim of this study was to explore sex and gender differences regarding aortic events in Marfan patients. We analysed all data from our connective tissue disorder database. Only patients with Marfan syndrome were included. For analysis, patients were divided by sex. Female patients were further divided into 2 subgroups; with vs without children. Aortic events were defined as Stanford type A or type B aortic dissection or any aortic intervention. A population of 183 Marfan patients was analysed for the purpose of this study. One-hundred-four (57%) were male and 79 (43%) were female patients. Thirty-seven (47%) of the 79 female patients had at least one child. Male patients had a significantly higher probability of experiencing an aortic event (p = 0.015) compared to female patients. However, there was no increased probability for recurrent events in male patients compared to female patients (p = 0.063). Follow-up revealed no sex and gender differences in the occurrence of Stanford type A or B aortic dissection between male and female patients (p = 0.324/p = 0.534). While 11% of women with children suffered from peripartum aortic events, 24% experienced Stanford Type A aortic dissection unrelated to pregnancy. Male patients have a higher risk of aortic events than female patients. The majority of women were not aware of their Marfan syndrome diagnosis before conceiving. One out of ten women suffered from peripartum Stanford Type A or B aortic dissection. Twice as many female patients with children suffered from aortic dissection unrelated to childbirth. There were no sex and gender differences affecting mortality in Marfan patients.