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Spontaneous coronary artery dissection: a Western Denmark Heart Registry study
K H Mortensen1, L Thuesen, I B Kristensen
1Medical Department M (Diabetes and Endocrinology) and Research Laboratories, Aarhus University Hospital, Aarhus Hospital NBG, Aarhus, Denmark. kristian.havmand@ki.au.dk
Summary
Spontaneous coronary artery dissection (SCAD) is rare, affecting younger women and often the left descending artery. Early diagnosis and treatment improve prognosis, with 81% event-free survival at 24 months.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome (ACS) with significant acute mortality.
- Long-term outcomes and comprehensive epidemiological data for SCAD remain less well-defined.
Purpose of the Study:
- To determine the incidence and identify predictors of SCAD.
- To evaluate the long-term prognosis and outcomes of patients diagnosed with SCAD.
Main Methods:
- A retrospective study utilizing data from the Western Denmark Heart Registry and the Forensic Institute at Aarhus University (1999-2007).
- Case identification and analysis of angiographic and clinical data for patients with SCAD.
Main Results:
- SCAD incidence was 0.7 per 1,000 angiograms (2.0 per 1,000 ACS cases), predominantly affecting women (77%) with a mean age of 48.7 years.
- The left descending artery (LAD) was the most common site; cardiovascular risk factors and coronary atherosclerosis were similar between genders.
- Major adverse cardiac event (MACE)-free survival was 81% at 24 months, with one case of recurrent SCAD and one sudden cardiac death during follow-up.
Conclusions:
- SCAD primarily impacts younger women and is a rare cause of ACS.
- Improved diagnostic capabilities and timely interventional treatments appear to enhance SCAD patient prognosis compared to historical data.
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