Incidence of Spontaneous coronary artery dissection on the rise, finds study

Spontaneous coronary artery dissection (SCAD) has been described as an infrequent cause of acute coronary syndrome (ACS). Knowledge about the disease is still limited and SCAD might still be underdiagnosed.

Patients with SCAD between 1997 and 2021 at the University Hospital Zurich, Switzerland, were included. Incidences were assessed as total numbers and proportions of ACS cases. Clinical data were collected from medical records and angiographic findings were reviewed. Major adverse cardiac events (MACE) were defined as the composite of all-cause death, cardiac arrest, SCAD recurrence or progression, other myocardial infarction, and stroke.

Results

One hundred fifty-six SCAD cases were included in this study. The incidence increased significantly in total (p < 0.001) and relative to ACS cases (p < 0.001). This was based on an increase of shorter lesions (p = 0.004), SCAD type 2 (p < 0.001), and lesions in side branches (p = 0.014), whereas lesions in the left main coronary artery and proximal segments were decreasing (p-values 0.029 and < 0.001, respectively). There was an increase in conservative therapy (p < 0.001). The rate of MACE (24%) was stable, however, there was a reduced proportion of patients with a need for intensive care treatment (p = 0.017).

SCAD represents an important entity of ACS that still might be underappreciated. The increasing incidence of SCAD is likely based on better awareness and familiarity with the disease. A lower need for intensive care treatment suggests positive effects of the increasing implementation of conservative management.

Reference:

Michael Würdinger, Victor Schweiger, Thomas Gilhofer, Victoria L. Cammann, Annika Badorff, Iva Koleva, Davide Di Vece, David Niederseer, Alessandro Candreva, Jonathan Michel, Alexander Gotschy, Julia Stehli, Barbara E. Stähli, Jelena R. Ghadri, Christian Templin. Twenty-five-year trends in incidence, angiographic appearance, and management of spontaneous coronary artery dissection, International Journal of Cardiology,Volume 395,

2024,131429,ISSN 0167-5273,https://doi.org/10.1016/j.ijcard.2023.131429.

(https://www.sciencedirect.com/science/article/pii/S0167527323014596)

Keywords:

Incidence, Spontaneous, coronary artery, dissection, rise, International Journal of Cardiology, Spontaneous coronary artery dissection; SCAD; Trends; Incidence; Types; Management, Michael Würdinger, Victor Schweiger, Thomas Gilhofer, Victoria L. Cammann, Annika Badorff, Iva Koleva, Davide Di Vece, David Niederseer, Alessandro Candreva, Jonathan Michel, Alexander Gotschy, Julia Stehli, Barbara E. Stähli, Jelena R. Ghadri, Christian Templin