Current challenges in treatment and management of spontaneous coronary artery dissection

Area of Science:

• Cardiology
• Vascular Biology

Background:

• Spontaneous coronary artery dissection (SCAD) is an infrequent but increasingly recognized cause of acute coronary syndrome (ACS).
• Pathophysiology involves separation of coronary arterial wall layers, leading to ACS-like symptoms and high recurrence rates.
• SCAD predominantly affects middle-aged females, with a notable lack of comprehensive literature on its short- and long-term management.

Purpose of the Study:

• To review current literature on risk factors associated with SCAD.
• To explore considerations for both short- and long-term management of SCAD.
• To highlight the absence of randomized controlled trials guiding SCAD treatment.

Main Methods:

• Systematic review of existing literature on spontaneous coronary artery dissection.
• Analysis of reported risk factors, clinical presentations, and management strategies.
• Identification of gaps in current research, particularly the lack of clinical trials.

Main Results:

• SCAD is an emerging cause of ACS, particularly in middle-aged women.
• Management strategies include percutaneous coronary intervention, surgical revascularization, antithrombotic therapy, and beta-blocker therapy.
• Significant lack of evidence-based guidelines due to limited randomized controlled trials.

Conclusions:

• Further research, including randomized controlled trials, is crucial for optimizing SCAD management.
• Understanding risk factors and long-term outcomes is essential for improving patient care.
• Current therapeutic approaches require more robust evidence to guide clinical decision-making.