Conditions and Factors Associated With Spontaneous Coronary Artery Dissection (from a National Population-Based Cohort Study)
Section snippets
Methods
We performed the analysis using the NIS database, a component of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. The NIS aggregates yearly data from over 8 million hospital stays involving over 1,000 hospitals and provides nationwide information on hospital utilization, charges, and quality of care (http://www.hcup-us.ahrq.gov/db/nation/nis/nisrelatedreports.jsp). Data were extracted from the NIS using ICD-9 codes from January 1, 2004, to
Results
A total of 66,360 of patients were diagnosed with SCAD. The mean age was 63.1 ± 13.2 years and 44.2% were women. SCAD and its associated conditions are presented in Figure 1. SCAD was associated with <1% each of coronary spasm, cocaine abuse, amphetamine abuse, migraine disorder, rheumatoid arthritis, Ehlers-Danlos syndrome, Marfan syndrome, α1-antitrypsin deficiency, adult polycystic kidney disease, polyarteritis nodosa, Kawasaki disease, celiac disease, granulomatosis polyangiitis, steroid
Discussion
To the best of our knowledge, this is the first study about conditions related to SCAD using a national database. There were 2 main findings. First, consistent with previously published case reports, we demonstrated that SCAD was associated with a variety of heterogeneous conditions, many of which are not associated with traditional ACS.4, 5,10, 12 Second, our study highlighted the use of a large database potentially to characterize an uncommon disease such as SCAD.
Although SCAD is mainly
Disclosures
Dr. Deepak L. Bhatt discloses the following relations—Advisory Board: Cardax, Elsevier Practice Update Cardiology, Medscape Cardiology, Regado Biosciences; Board of Directors: Boston VA Research Institute, Society of Cardiovascular Patient Care, TobeSoft; Chair: American Heart Association Quality Oversight Committee; Data Monitoring Committees: Baim Institute for Clinical Research (formerly Harvard Clinical Research Institute, for the PORTICO trial, funded by St. Jude Medical, now Abbott),
Acknowledgment
None.
References (42)
- 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.
Marfan's syndrome
Lancet
(2005) - et al.
Spontaneous coronary artery dissection associated with cocaine use: a case report and brief review
Cardiovasc Pathol
(2001) - et al.
Usefulness of cardiac rehabilitation after spontaneous coronary artery dissection
Am J Cardiol
(2016) - et al.
Intravascular ultrasound assessment of spontaneous coronary artery dissection
Am J Cardiol
(2002) - et al.
Spontaneous coronary artery dissection: clinical outcomes and risk of recurrence
J Am Coll Cardiol
(2017) - et al.
Should we recommend cardiac rehabilitation in patients with spontaneous coronary artery dissection
J Am Coll Cardiol
(2018) - et al.
Prevalence of extracoronary vascular abnormalities and fibromuscular dysplasia in patients with spontaneous coronary artery dissection
Am J Cardiol
(2015) - et al.
Left main coronary artery dissection associated with emotional stress
Dis Mon
(2006) - et al.
Recurrent spontaneous coronary artery dissection: unexpected evolution and major role of emotional stress
Int J Cardiol
(2015)
Spontaneous coronary artery dissection associated with pregnancy
J Am Coll Cardiol
Vascular reactivity is impaired in genetic females taking high-dose androgens
J Am Coll Cardiol
Spontaneous coronary artery dissection and eosinophilic inflammation: a cause and effect relationship
Am J Med
Trends in incidence, characteristics, and in-hospital outcomes of patients presenting with spontaneous coronary artery dissection (from a national population-based cohort study between 2004 and 2015)
Am J Cardiol
Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes
Circ Cardiovasc Interv
Active inflammatory bowel disease and coronary artery dissection
Postgrad Med J
Spontaneous coronary artery dissection in a patient with systemic lupus erythematosis
Hawaii Med J
Spontaneous coronary artery dissection and its association with heritable connective tissue disorders
Heart
Spontaneous coronary artery dissection in a 22-year-old man on lisdexamfetamine
Proc (Bayl Univ Med Cent)
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