Spontaneous coronary artery dissection had a 0.65% incidence, predominantly affected males (92.6%), mostly involved the LAD artery, and had 0% major adverse cardiac events at 1 month.
This retrospective cohort highlights an unusual male predominance in SCAD with excellent short-term outcomes and no MACE at 1 month, contrasting with typical female-predominant SCAD demographics.
Absolute Event Rate: 0% vs 0%
ABSTRACT We had retrospective evaluation analysis of 136 Spontaneous Coronary Artery Dissection (SCAD), diagnosed from 21,007 coronary angiograms (CAGs) done over 159 months from our two tertiary care hospitals in our city. SCAD was diagnosed and confirmed by at least two senior consultants using cine of CAGs. We had a global incidence of 0.65%, mean age of 50.2 years, male predominant (92.6%) from two centers. Had varied clinical presentation and the majority were acute coronary syndromes. They also underwent two-dimensional echocardiography (2D echo) for left ventricular (LV) function assessment. CAG identifies a total of 148 SCAD lesions from 136 patients and the majority were left anterior descending (LAD) SCAD (78) and right coronary artery SCAD (43). Managed medically in 95 and revascularization in 41. Out of 41, 25 for per cutaneous intervention (PCI) and 16 for coronary artery bypass graft. Out of 25 PCI, 5 had direct PCI on SCAD vessel and 20 had PCI on non-SCAD vessels to improve collaterals and to relieve symptoms. No pregnancy-related SCAD or major adverse cardiac events (MACE) at 1 month were noted. We observed that there are many differences noted in world statistics. All are alive, no pregnancy associated SCAD or MACE, male and LAD SCAD lesion dominance, majority had normal-to-mild LV systolic dysfunction by 2D echo and managed medically. This probably explains ethical and geographical variations, diet, body mass index and many more. Higher detection rates likely reflect improved angiography quality, hardware, and operator expertise. Limitations include the absence of intra vascular ultra sonography and optical coherence tomography imaging.
Reddy et al. (Wed,) reported a other. Spontaneous coronary artery dissection had a 0.65% incidence, predominantly affected males (92.6%), mostly involved the LAD artery, and had 0% major adverse cardiac events at 1 month.