Clinical implications of arterial hypertension in patients with spontaneous coronary artery dissection

Alfonso, Fernándo; García-Guimarães, Marcos; Alvarado, Teresa; Sanz‐Ruiz, Ricardo; Roura, Gerard; Amat‐Santos, Ignacio J.; Altisent, Omar Abdul‐Jawad; Tizón‐Marcos, Helena; Flores-Ríos, Xacobe; Masotti, Mónica; Prado, Armando Pérez-de; Ferre, Georgina Fuentes; Ruíz-Poveda, Fernando Lozano; Valero, Ernesto; Portero-Portaz, Juan José; Díez‐Villanueva, Pablo; Salamanca, Jorge; Bastante, Teresa; Rivero, Fernando

doi:10.1097/mca.0000000000001043

Cited by 9 publications

(2 citation statements)

References 31 publications

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“…Alfonso et al, 2022 26 Diez-Villanueva et al, 2021 27 Diez-Villanueva et al, 2021 28 Garcia-Guimaraes et al, 2021 29 Garcia-Guimaraes et al, 2022 30 Spanish Registry on SCAD Garcia-Guimaraes et al, 2022 30 Latest study with highest number of patients Macaya et al, 2019 31 Carss et al, 2020 32 UK SCAD Registry Carss et al, 2020 32 Latest study with highest number of patients Rogowski et al, 2017 33 Seidl et al, 2021 34 Kantonsspital St. Gallen cohort Seidl et al, 2021 34 Latest study with highest number of patients…”

Section: Time To Angiographymentioning

confidence: 99%

Regional and temporal variations of spontaneous coronary artery dissection care according to consensus recommendations: a systematic review and meta-analysis

Dang,

Othman,

Sheahen

et al. 2023

Open Heart

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AimThe first expert consensus documents on management of patients with spontaneous coronary artery dissection (SCAD) were published in 2018. Worldwide quality of care, as measured by adherence to these recommendations, has not been systematically reviewed. We aim to review the proportion of patients with SCAD receiving consensus recommendations globally, regionally and, determine differences in practice before and after 2018.Methods and resultsA systematic review was performed by searching four main databases (Medline, Embase, SCOPUS, CINAHL) from their inception to 16 June 2022. Studies were selected if they included patients with SCAD and reported at least one of the consensus document recommendations. 53 studies, n=8456 patients (mean 50.1 years, 90.6% female) were included. On random effects meta-analysis, 92.1% (95% CI 89.3 to 94.8) received at least one antiplatelet, 78.0% (CI 73.5 to 82.4) received beta-blockers, 58.7% (CI 52.3 to 65.1) received ACE inhibitors or aldosterone receptor blockers (ACEIs/ARBs), 54.4% (CI 45.4 to 63.5) were screened for fibromuscular dysplasia (FMD), and 70.2% (CI 60.8 to 79.5) were referred to cardiac rehabilitation. Except for cardiac rehabilitation referral and use of ACEIs/ARBs, there was significant heterogeneity in all other quality-of-care parameters, across geographical regions. No significant difference was observed in adherence to recommendations in studies published before and after 2018, except for lower cardiac rehabilitation referrals after 2018 (test of heterogeneity, p=0.012).ConclusionThere are significant variations globally in the management of patients with SCAD, particularly in FMD screening. Raising awareness about consensus recommendations and further prospective evidence about their effect on outcomes may help improve the quality of care for these patients.

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Section: Time To Angiographymentioning

confidence: 99%

Regional and temporal variations of spontaneous coronary artery dissection care according to consensus recommendations: a systematic review and meta-analysis

Dang,

Othman,

Sheahen

et al. 2023

Open Heart

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“…It has been suggested that hypertension increases pressure on the coronary artery walls, making them more susceptible to SCAD recurrence [7]. In a previous study, compared with normotensive SCAD patients, hypertensive SCAD patients were older and had more frequent multivessel involvement and more severe lesions; however, the risk of recurrence was similar [39].…”

Section: Risk Factors and Associationsmentioning

confidence: 99%

Recurrent spontaneous coronary artery dissection

Wang

Yuan

et al. 2022

Coronary Artery Disease

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Spontaneous coronary artery dissection (SCAD) is a significant cause of myocardial infarction (MI) and is more prevalent in pregnancy. The disease is being increasingly appreciated and diagnosed with the development and application of coronary angiography and intravascular imaging. Recurrent spontaneous coronary artery dissection (R-SCAD) is relatively common, with recurrence rates ranging from 8 to 27%. R-SCAD usually involves anatomical sites different from the original SCAD lesion and can cause MI, ventricular arrhythmias, and cardiogenic shock. This study aims to conduct a comprehensive review of R-SCAD to identify early risk factors and guide prevention policies and interventions. In addition, the risk of R-SCAD in subsequent pregnancies in women with a history of SCAD is discussed.

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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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Clinical implications of arterial hypertension in patients with spontaneous coronary artery dissection

Cited by 9 publications

References 31 publications

Regional and temporal variations of spontaneous coronary artery dissection care according to consensus recommendations: a systematic review and meta-analysis

Regional and temporal variations of spontaneous coronary artery dissection care according to consensus recommendations: a systematic review and meta-analysis

Recurrent spontaneous coronary artery dissection

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

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