Recurrent spontaneous coronary artery dissection

Kok, Susan N.; Tweet, Marysia S.

doi:10.1080/14779072.2021.1877538

Cited by 12 publications

(14 citation statements)

References 75 publications

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“…In addition, due to the absence of common predisposing factors like vasculitis, systemic inflammatory disease, pregnancy, substance use and stress, we identified this case as idiopathic SCAD. Studies similar to our patient showed that SCAD recurs with a frequency of more than 10% and can often occur in a different coronary artery (17,18). In addition, it suggests that recurrence may be associated with hypertension and coronary tortuosity (18).…”

Section: Discussionsupporting

confidence: 73%

“…Studies similar to our patient showed that SCAD recurs with a frequency of more than 10% and can often occur in a different coronary artery (17,18). In addition, it suggests that recurrence may be associated with hypertension and coronary tortuosity (18). Although long-term treatment is not clearly known, medical treatment and follow-up seem to be a good alternative in patients with recurrent SCAD (13,18).…”

Section: Discussionsupporting

confidence: 67%

“…In addition, it suggests that recurrence may be associated with hypertension and coronary tortuosity (18). Although long-term treatment is not clearly known, medical treatment and follow-up seem to be a good alternative in patients with recurrent SCAD (13,18).…”

Section: Discussionmentioning

confidence: 99%

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Medikal Tedavi ile İyileşen Yaygın, İdiyopatik, Tekrarlayan Spontan Koroner Arter Diseksiyonu

Akbay

Özer

Adar

et al. 2021

Düzce Tıp Fakültesi Dergisi

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Spontaneous coronary artery dissection is a rare cause of sudden cardiac death and acute coronary syndrome, and mainly affects young female. Treatment of this condition depends on the clinical features, hemodynamic and angiographic findings of the patient, but due to the rarity of the disease, guideline support was insufficient until the last period. Depending on the condition of the patient and the coronary blood flow, medical observation, percutaneous coronary intervention or coronary artery bypass graft surgery are used in the treatment. We present a young female patient who underwent emergency coronary artery bypass graft surgery after spontaneous left main coronary artery dissection four years ago and was recently diagnosed with extensive spontaneous coronary artery dissection in her right coronary artery. After the diagnosis, the patient was given medical treatment and recovered completely.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 67%

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Medikal Tedavi ile İyileşen Yaygın, İdiyopatik, Tekrarlayan Spontan Koroner Arter Diseksiyonu

Akbay

Özer

Adar

et al. 2021

Düzce Tıp Fakültesi Dergisi

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“…Identifying the determinants of SCAD recurrence remains an ongoing challenge and research priority [5]. Previous studies suggested potential predictors for SCAD recurrence such as hypertension, migraine headaches, fibromuscular dysplasia (FMD), and severe coronary tortuosity [3]. With regard to preventive measures, a prior meta-analysis showed that revascularization was not associated with a reduced SCAD recurrence compared with conservative medical therapy [6].…”

Section: Introductionmentioning

confidence: 99%

“…Spontaneous coronary artery dissection (SCAD), defined as the nontraumatic, nonatherogenic dissociation of the coronary artery wall, accounts for 1–4% of the acute coronary syndrome among patients undergoing angiographic evaluation and 15–20% of myocardial infarctions during pregnancy or the peripartum period [1,2]. SCAD commonly affects young and middle-aged women without atherosclerotic risk factors and may recur as a new dissection that is temporally separated from the index event, with an incidence ranging from 5% over a median follow-up of 22 months to 29% over a median follow-up of 10 years [3,4]. Although the mortality rate after the index event is low and estimated at 1–2% over 3 years, SCAD recurrence is a major concern to patients and clinicians as it may reinstate chest pain, cardiac complications, and emotional or psychological consequences [1,5].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with recurrent spontaneous coronary artery dissection: a systematic review and meta-analysis

Chi

Najafi

Montazerin

et al. 2022

Coronary Artery Disease

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BackgroundThe risk of recurrent spontaneous coronary artery dissection (SCAD) is a major concern to SCAD patients and clinicians. Identifying the high-risk subsets of recurrent SCAD remains an ongoing challenge. The meta-analysis aimed to assess the potential predictors for SCAD recurrence. Methods A literature search was performed in PubMed to collect studies that assessed potential factors associated with recurrence of SCAD among angiographically confirmed SCAD patients, including pregnancy, ventricular arrhythmia at presentation, history of hypertension, migraine, fibromuscular dysplasia (FMD), extracoronary vascular abnormalities (EVA), recent emotional or physical stress, and use of thienopyridine, beta-blocker, or statin. A meta-analytic approach was employed to estimate the relative risk (RR) with a 95% confidence interval (CI) by fitting random-effects models using the generic inverse variance weighted method. ResultsA total of 14 studies representing 4206 SCAD patients were included. Hypertension (RR, 1.49; 95% CI, 1.05-2.12; P = 0.0247) and FMD (RR, 2.02; 95% CI, 1.03-3.94; P = 0.0404) were associated with a greater risk of SCAD recurrence. The use of beta-blocker (RR, 0.51; 95% CI, 0.33-0.77; P = 0.0013) was associated with a lower risk of SCAD recurrence. Pregnancy, ventricular arrhythmia at presentation, migraine, EVA, recent emotional or physical stress, and use of thienopyridine or statin were not significantly associated with recurrent SCAD (P > 0.05).Conclusion SCAD patients with hypertension or FMD were at a higher risk of recurrence, whereas beta-blocker usage was related to a reduced risk. These findings may provide insights into risk prediction and management after the SCAD episode.

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Spontaneous Coronary Artery Dissection (SCAD): An Overview of the Condition, Diagnostic Work Up and Management

Namkoong,

Colella,

Carvalho

et al. 2023

Advances in Biochemistry in Health and Disease

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Recurrent spontaneous coronary artery dissection

Cited by 12 publications

References 75 publications

Medikal Tedavi ile İyileşen Yaygın, İdiyopatik, Tekrarlayan Spontan Koroner Arter Diseksiyonu

Medikal Tedavi ile İyileşen Yaygın, İdiyopatik, Tekrarlayan Spontan Koroner Arter Diseksiyonu

Factors associated with recurrent spontaneous coronary artery dissection: a systematic review and meta-analysis

Spontaneous Coronary Artery Dissection (SCAD): An Overview of the Condition, Diagnostic Work Up and Management

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