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Impact of connective tissue disease features on patients with spontaneous coronary artery dissection

Sant Kumar1, George Bcharah2, Mahmoud Abdelnabi2

  • 1Department of Cardiovascular Disease, Mayo Clinic Hospital, Phoenix, AZ, USA; Department of Cardiovascular Disease, Creighton University School of Medicine, Phoenix, AZ, USA.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|June 27, 2025
PubMed

Insights

Connective tissue disorder (CTD) features are common in spontaneous coronary artery dissection (SCAD) patients and significantly increase the risk of adverse cardiovascular events, particularly recurrent myocardial infarction (MI). Recognizing these features aids in better risk stratification and management for SCAD patients.

Area of Science:

  • Cardiology
  • Genetics
  • Internal Medicine

Background:

  • Spontaneous coronary artery dissection (SCAD) is a growing cause of myocardial infarction (MI).
  • SCAD is often linked to connective tissue disorder (CTD) features like joint hypermobility and scoliosis.
  • The impact of CTD features on SCAD patient outcomes is not well understood.

Purpose of the Study:

  • To determine the prevalence of CTD features in SCAD patients.
  • To evaluate the association between CTD features and adverse cardiovascular outcomes.
  • To improve risk stratification and clinical management for SCAD patients.

Main Methods:

  • Retrospective analysis of 1380 SCAD patients (2018-2024).
  • Stratification based on presence/absence of CTD features (ICD-10 codes, chart review).
  • Propensity score matching and logistic regression to assess outcomes (recurrent MI, stroke, mortality).

Main Results:

  • CTD features were present in 26.7% of SCAD patients; joint conditions were most common (20%).
  • Patients with CTD features had higher rates of adverse cardiovascular outcomes (57.9% vs. 41.0%, p < 0.001).
  • CTD features and joint conditions independently predicted worse outcomes (OR: 2.77 and 3.19, respectively).

Conclusions:

  • CTD features are prevalent in SCAD patients.
  • These features are linked to significantly higher rates of adverse cardiovascular events, especially recurrent MI.
  • Identifying CTD features can enhance risk assessment and guide targeted SCAD management.
Abstract

Keywords:
Connective tissue diseasesConnective tissue featuresMajor adverse cardiovascular eventsSpontaneous coronary artery disease

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