May emergency hypertension be reason of spontaneous coronary artery dissection?

Tatlı, Ersan; Altun, Armağan

doi:10.1016/j.ijcard.2008.11.079

Cited by 2 publications

(1 citation statement)

References 11 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Classical SCAD triggers, as isometric exercise or the Valsalva maneuver, cause surges in blood pressure. Several isolated case-reports have described the occurrence of SCAD in patients presenting with systolic hypertension or with emergency hypertensive crisis, further suggesting the possibility of a causal relationship [1][2][3][4]21,22]. Interestingly, endothelin, a potent vasoconstrictor, has been implicated in the pathogenesis of SCAD associated with arterial hypertension [23].…”

Section: Previous Studiesmentioning

confidence: 99%

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

Alfonso

García-Guimarães

Alvarado

et al. 2021

Coronary Artery Disease

View full text Add to dashboard Cite

Background Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognized cause of acute coronary syndrome. Many patients with SCAD have associated coronary risk factors. However, the implications of arterial hypertension in SCAD patients remain unknown.Objective This study sought to assess the clinical implications of arterial hypertension in a nationwide cohort of patients with SCAD. MethodsThe Spanish SCAD registry (NCT03607981) prospectively enrolled 318 consecutive patients. All coronary angiograms were centrally analyzed to confirm the diagnosis of SCAD. Patients were classified according to the presence of arterial hypertension. ResultsOne-hundred eighteen patients (37%) had a diagnosis of arterial hypertension. Hypertensive SCAD patients were older (60 ± 12 vs. 51 ± 9 years old) and had more frequently dyslipidemia (56 vs. 23%) and diabetes (9 vs. 3%) but were less frequently smokers (15 vs. 35%) than normotensive SCAD patients (all P < 0.05). Most patients in both groups were female (90 vs. 87%, NS) and female patients with hypertension were more frequently postmenopausal (70 vs. 47%, P < 0.05). Hypertensive SCAD patients had more severe lesions and more frequently multivessel involvement (15 vs. 7%, P < 0.05) and coronary ectasia (19 vs. 7%, P < 0.05) but showed a similar prevalence of coronary tortuosity (34 vs. 26%, NS). Revascularization requirement was similar in both groups (17 vs. 26%, NS) but procedural success was significantly lower (65 vs. 88%, P < 0.05) and procedural-related complications more frequent (65 vs. 41%, P < 0.05) in SCAD patients with hypertension.

show abstract