The risk for XXXX in @entity1614 .

@entity1 @entity1614 @entity204 @entity1580
BACKGROUND: Aortic dissections involving the descending aorta are a major clinical problem in @entity1 with @entity1614 . OBJECTIVES: The purpose of this study was to identify clinical parameters associated with @entity1580 and to develop a risk model to predict @entity1580 in @entity1 with @entity1614 . METHODS: @entity1 with the diagnosis of @entity1614 and magnetic resonance imaging or computed tomographic imaging of the aorta were followed for a median of 6 years for the occurrence of type B dissection or the combined end point of @entity1580 , distal aortic surgery, and @entity204 . A model using various clinical parameters as well as genotyping was developed to predict the risk for type B dissection in @entity1 with @entity1614 . RESULTS: Between 1998 and 2013, 54 type B aortic dissections occurred in 600 @entity1 with @entity1614 (mean age 36    14 years, 52% male). Independent variables associated with @entity1580 were prior prophylactic aortic surgery (hazard ratio: 2.1; 95% confidence interval: 1.2 to 3.8; p  = 0.010) and a proximal descending aorta diameter  >= 27 mm (hazard ratio: 2.2; 95% confidence interval: 1.1 to 4.3; p  = 0.020). In the risk model, the 10-year occurrence of @entity1580 in low-, moderate-, and high-risk @entity1 was 6%, 19%, and 34%, respectively. Angiotensin II receptor blocker therapy was associated with fewer type B aortic dissections (hazard ratio: 0.3; 95% confidence interval: 0.1 to 0.9; p  = 0.030). CONCLUSIONS: @entity1 with @entity1614 with prior prophylactic aortic surgery are at substantial risk for @entity1580 , even when the descending aorta is only slightly dilated. Angiotensin II receptor blocker therapy may be  protective in the prevention of type B aortic dissections.
