Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea

Abstract

Background/Aims We aimed to evaluate the prevalence, characteristics, and clinical outcomes of spontaneous coronary artery dissection (SCAD) in young female patients with acute myocardial infarction (AMI). Methods We identified 8,250 patients diagnosed with AMI who underwent coronary angiogram from the Chonnam National University Hospital database, Gwangju, Korea, between November 2005 and September 2017. A total of 148 female patients aged less than 60 years with a history of AMI were retrospectively studied and the characteristics and clinical outcomes were evaluated for all SCAD patients. Results Among female patients with AMI aged less than 60 years, the prevalence of SCAD was 8.78% (13 of 148). Based on the angiographic classification, type 2 SCAD was most commonly observed on angiograms in 69.2% of the cases (nine of 13), followed by type 3 in 23.1% (three of 13), and type 1 in 7.7% (one of 13). Furthermore, the left anterior descending (LAD) artery was the most commonly affected coronary artery (76.9%, 10 of 13 cases) and the distal segments of the coronary arteries were the most common sites of SCAD (92.3%, 12 of 13). Regarding the clinical outcomes, one of 13 patients experienced repeat revascularization during the following 31 months. Conclusions The prevalence of SCAD was 8.7%, indicating that SCAD is not rare, among female patients aged less than 60 years with AMI in Korea. Type 2 SCAD was most commonly observed on angiogram. Moreover, the distal portion of the LAD was the segment most commonly affected by SCAD. The long-term clinical outcomes were favorable in patients surviving SCAD.

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

“…In addition, the model relationship between coronary artery lesions and risk factors in young patients with acute myocardial infarction is still uncertain. Smoking and dyslipidemia are major risk factors for AMI, but the new research points out that high-risk occupations such as staying up late and dependence on electronic products may be new risk factors [ 7 ]. Based on this, this study analyzed the clinical data of 150 patients with AMI to explore the location and characteristics of coronary lesions in young patients with AMI during coronary angiography to analyze the relationship between coronary responsibility lesions and left and right coronary advantages, and to reveal possible new risk factors for the disease.…”

Mortality in spontaneous coronary artery dissection: A systematic review and meta‐analysis

“…Table 1 provides an overview of the characteristics of the 34 included studies 2,4‐6,11‐40 . The mean duration of follow‐up was 33 ± 20 months.…”

Comment on “Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea”

“…I immediately read with great attention and interest the significant and well-presented article recently published in an issue of this journal by Kim et al [1] entitled "Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea." They evaluated the prevalence, characteristics, and clinical outcomes of spontaneous coronary artery dissection (SCAD) in young female patients with acute myocardial infarction in Korea.…”

“…Although various potential risk factors for SCAD have been evaluated in the study of Kim et al [1], the influence of hormone has not. However, clinical data have demonstrated that patients under either oral contraceptive use or hormone replacement therapy have an increased risk for developing SCAD.…”

“…If the prior medical history of oral contraceptive use or hormone replacement therapy has been evaluated in the study presented by Kim et al [1], it www.kjim.org https://doi.org/10.3904/kjim.2019.236…”