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Conditions and Factors Associated With Spontaneous Coronary Artery Dissection (from a National Population-Based

Chayakrit Krittanawong1, Anirudh Kumar2, Kipp W Johnson3

  • 1Department of Internal Medicine, Icahn School of Medicine at Mount Sinai St' Luke and Mount Sinai West Hospitals, New York, New York.

The American Journal of Cardiology
|November 28, 2018
PubMed

Insights

Most spontaneous coronary artery dissections (SCAD) lack clear links to other diseases or risk factors. This study analyzed SCAD patient data to understand associated conditions and their prevalence in the US population.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Epidemiology

Background:

  • Spontaneous coronary artery dissection (SCAD) pathophysiology is complex, involving systemic arteriopathies, inflammatory diseases, and external factors.
  • The population-level frequency of these associated conditions in SCAD patients is not well-established.

Purpose of the Study:

  • To evaluate the heterogeneous phenotypes of SCAD in the United States.
  • To determine the prevalence of various associated conditions in a large SCAD patient cohort.

Main Methods:

  • Analysis of data from the Nationwide Inpatient Sample (NIS) in the US.
  • Inclusion of patients diagnosed with SCAD between January 1, 2004, and September 31, 2015.
  • Examination of demographic data and co-occurring conditions in 66,360 SCAD patients.

Main Results:

  • The average SCAD patient was 63.1 years old, with 44.2% being women.
  • Identified conditions included depression (5.14%), rheumatoid arthritis (1.0%), anxiety (0.96%), and migraine disorders (0.82%).
  • Less common associations included systemic lupus erythematosus (0.42%), cocaine abuse (0.38%), fibromuscular dysplasia (0.16%), and Ehlers-Danlos syndrome (0.02%).

Conclusions:

  • The majority of SCAD cases did not present with apparent concomitant arteriopathy, inflammatory disorder, or identifiable risk factors.
  • SCAD's heterogeneous nature suggests multifactorial origins, but specific associations are infrequent in the general population.
  • Further research is needed to fully elucidate the diverse triggers and underlying mechanisms of SCAD.

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