Coronary Artery DiseaseManagement and Long-Term Prognosis of Spontaneous Coronary Artery Dissection
Section snippets
Methods
From 2001 to December 2013, patients with angiographic diagnosis of SCAD admitted to institutions participating in the study were evaluated. Patients were identified using retrospective and prospective methods. Patients were retrospectively identified using a local institutional database that specifically included the term “spontaneous coronary dissection” among the diagnostic variables. From 2010, patients with diagnoses of SCAD were also included in the study. Patients were analyzed as
Results
We identified 134 patients with SCAD. Forty-six patients (34%) were retrospectively identified, and 88 patients (66%) were prospectively identified. Baseline characteristics and clinical presentation are listed in Table 1. The average age was 52 ± 11 years (range 28 to 86), and 109 (81%) were women. Almost all patients (124 of 134 [93%]) were admitted with acute coronary syndromes (ACS). Forty-nine percent of patients presented with STEMI and 40% with non–ST-segment elevation MI. Single-vessel
Discussion
The present observational study reports clinical and procedural features as well as long-term prognosis of 1 of the largest series of patients with SCAD described to date. The main findings of the present study are that the short- and long-term prognosis are generally favorable, procedural success of PCI is lower than expected, and case-specific treatment seems feasible and safe.
In the present registry, in-hospital prognosis was generally favorable, with a mortality rate of approximately 2%,
Disclosures
The authors have no conflicts of interest to disclose.
References (25)
- et al.
Spontaneous coronary artery dissection: long-term follow-up of a large series of patients prospectively managed with a “conservative” therapeutic strategy
JACC Cardiovasc Interv
(2012) - et al.
Management and outcome of spontaneous cor- onary artery dissection: conservative therapy versus revascularization
Int J Cardiol
(2013) - et al.
Use of a morphologic classification to predict clinical outcome after dissection from coronary angioplasty
Am J Cardiol
(1991) - et al.
Intravascular ultrasound assessment of spontaneous coronary artery dissection
Am J Cardiol
(2002) - et al.
Progression of dissection due to residual dissection after intracoronary stenting for spontaneous coronary dissection at bi-furcation site of LAD and diagonal artery
Int J Cardiol
(2008) - et al.
Coronary stenting in the setting of sponta-neous coronary artery dissection
Int J Cardiol
(1998) - et al.
Spontaneous multivessel coronary dissection in a long-distance runner successfully treated with oral antiplatelet therapy: a case report and review of the literature
J Invasive Cardiol
(2002) - et al.
Spontaneous coronary artery dissection: stent it or wait for healing?
Heart
(2003) - et al.
Spontaneous coronary artery dissection: case series and review
J Invasive Cardiol
(2008) - et al.
Spontaneous coronary artery dissection: aggressive vs. conservative therapy
J Invasive Cardiol
(2010)
Spontaneous coronary artery dissection: report of two cases and a 50-year review of the literature
Cardiol Rev
Management of spontaneous coronary artery dissection in the primary percutaneous coronary intervention era
J Invasive Cardiol
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