Spontaneous Coronary Artery Dissection in Acute Coronary Syndrome: Report of a Series of Cases with 17 Patients

Godinho, Ana Rita; Vasconcelos, M. Teresa S. D.; Araújo, Vítor; Maciel, Maria Júlia

doi:10.5935/abc.20160170

Cited by 7 publications

(9 citation statements)

References 12 publications

(26 reference statements)

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“…Overall, 1458 titles and abstracts were first identified; after exclusion according to pre-specified criteria, 16 observational studies were included in the present pooled analysis (Figure 1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] No randomized clinical trial was found. A total of 444 patients were included.…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, most registries only report on combined outcomes at last available follow-up, but individual outcomes within the first crucial year after SCAD are rarely described and are mostly limited to small case reports and series. 18,20,21 Likewise, long-term comparisons of clinical outcomes of conservative versus invasive treatment strategies for SCAD have been reported in individual studies and meta-analyses describing similar clinical outcomes and lower target vessel revascularizations in medically-managed patients compared to those undergoing revascularization. 6,30 Nevertheless, MACE incidence within the first year after SCAD according to treatment strategy is still unknown.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes during the first year following spontaneous coronary artery dissection: A systematic timeframe pooled analysis

Bocchino

Franchin

Angelini

et al. 2021

Cathet Cardio Intervent

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Objectives: We aimed to compare the incidence and timing of major adverse cardiovascular events (MACE) within the first year after spontaneous coronary artery dissection (SCAD) according to the management strategy: conservative versus invasive.Background: Treatment of SCAD remains controversial.Methods: A pooled analysis of studies providing separate individual clinical outcomes for conservative and invasive treatment strategies within 1 year after SCAD was performed. The primary outcome measure was MACE incidence within three predefined study periods after SCAD, namely "in-hospital", "discharge-to-6-months"and "6-to-12-months". MACE was defined as a composite of all-cause death, myocardial infarction, target vessel revascularization, heart failure and SCAD recurrence.Results: A total of 16 studies (444 patients) were included; 277 (62%) patients were treated conservatively and 167 (38%) invasively. Within 1-year follow-up, 39 (67%) MACE occurred during the in-hospital period compared to 10 (17%) in the "discharge-to-6 months" period and 9 (16%) in the "6-to-12-months" period (p < 0.0001 for the overall comparison). MACE incidence was also significantly different between the three study periods in the conservatively-treated group (23 [78%] vs. 7 [23%] vs. 0 [0%], respectively; p < 0.0001) and the invasively-treated group (12 [66%] vs. 3 [17%] vs. 3 [17%], respectively; p < 0.0001), although no significant difference was found regarding MACE incidence in the intra-period comparisons between conservative and invasive treatment strategies.Conclusions: This pooled analysis showed that most MACE following SCAD occurred during the in-hospital period compared to the following two semesters, regardless of the treatment strategy. No difference regarding MACE incidence was found between conservative and invasive strategies in each study period.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Outcomes during the first year following spontaneous coronary artery dissection: A systematic timeframe pooled analysis

Bocchino

Franchin

Angelini

et al. 2021

Cathet Cardio Intervent

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“…6,8,11,13,30,31,33,36 One study reported that men presented with SCAD at a slightly younger age than women (mean age, 48.6 [SD, 9.8] years versus 52.3 [SD, 9.2] years; P =0.05). 37,38 Although SCAD has been reported in all major racial and ethnic groups, the majority of patients are white, a finding that may reflect referral and sampling bias and the demography of patients cared for at reporting centers.…”

Section: Epidemiologymentioning

confidence: 99%

Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association

Hayes¹,

Kim²,

Saw³

et al. 2018

Circulation

906

1,344

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Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented.

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“…After title and abstract evaluation, full text revision of the remaining 106 articles excluded 87 for a lack of adequate follow-up data, leaving 19 studies for inclusion in the final analysis ( Supplementary Fig. 1) [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Table 1 shows the prevalence meta-analyses for clinical characteristics from the included studies.…”

Section: Literature Search and Synthesismentioning

confidence: 99%

Systematic review and meta-analysis of the clinical characteristics and outcomes of spontanous coronary artery dissection

Franke

Nerlekar

Marshall

et al. 2021

International Journal of Cardiology

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Spontaneous Coronary Artery Dissection in Acute Coronary Syndrome: Report of a Series of Cases with 17 Patients

Cited by 7 publications

References 12 publications

Outcomes during the first year following spontaneous coronary artery dissection: A systematic timeframe pooled analysis

Outcomes during the first year following spontaneous coronary artery dissection: A systematic timeframe pooled analysis

Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association

Systematic review and meta-analysis of the clinical characteristics and outcomes of spontanous coronary artery dissection

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