TY - JOUR T1 - Spontaneous coronary artery dissection: Ten years’ experience of a tertiary center JO - Revista Portuguesa de Cardiologia T2 - AU - Proença,Tânia AU - Martins Carvalho,Miguel AU - Alves Pinto,Ricardo AU - Dias,Paula AU - Macedo,Filipe SN - 08702551 M3 - 10.1016/j.repc.2023.01.018 DO - 10.1016/j.repc.2023.01.018 UR - https://revportcardiol.org/pt-spontaneous-coronary-artery-dissection-ten-articulo-S0870255123000732 AB - IntroductionSpontaneous coronary artery dissection (SCAD) represents 1–4% of all acute coronary syndromes (ACS), and is a particularly important cause among young women and individuals with few cardiovascular risk factors. ObjectivesTo characterize clinical background, therapeutic management and clinical outcomes in a SCAD population. MethodsWe retrospectively analyzed all consecutive patients diagnosed with SCAD at a tertiary center between August 2009 and May 2020, with a median follow-up of 40 months (IQR 14–95 months). SCAD was classified according to the Saw angiographic SCAD classification. ResultsA total of 36 patients were included, 94% female, mean age 51 years (±11 years). A trigger was only detected in 8% and associated conditions in 31% of patients, mainly inflammatory or autoimmune systemic diseases and migraine. Most patients had non-ST-elevation ACS and 33% presented with ST-elevation ACS. The most frequent culprit lesion was the left anterior descending (LAD) artery (67%); mid to distal segments were the most affected (94%) and type 2 dissection the most prevalent (60%). Almost all patients were successfully medically managed, with only four undergoing percutaneous intervention. During follow-up, ischemic events recurred in 15% of patients and no patient died. Patients with type 2 dissection exhibited lower risk of recurrence compared to type 1 (p=0.049, OR=0.13). ConclusionSCAD patients were mainly young or middle-aged women; the LAD artery was the most affected vessel and type 2 dissection the most prevalent. This report showed for the first time a correlation between type 2 SCAD and lower risk of recurrence. ER -