| Title: |
In-hospital and one-year outcomes in spontaneous coronary artery dissection. Insights from the Spanish registry on SCAD (SR-SCAD) |
| Authors: |
Garcia Guimaraes, M; Diez-Villanueva, P; Macaya Ten, F; Masotti, M; Sanz-Ruiz, R; Roura, G; Nogales, J M; Abdul-Jawad Altisent, O; Flores-Rios, X; Jimenez-Kockar, M; Veiga, G; Camacho-Freire, S J; Velazquez, M; Alfonso, F |
| Source: |
European Heart Journal ; volume 42, issue Supplement_1 ; ISSN 0195-668X 1522-9645 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2021 |
| Description: |
Background Spontaneous coronary artery dissection (SCAD) is a relatively infrequent but well-known cause of acute coronary syndrome (ACS). Information about in-hospital evolution and adverse event during follow-up is still scarce and comes mostly from cohorts outside the European context. Purpose The aim of the present work was to evaluate in-hospital and one-year follow-up adverse events in a nationwide large prospective cohort of patients with SCAD. Methods The Spanish Registry on SCAD (NCT03607981) prospectively included patients with a diagnosis of SCAD from 34 Spanish university hospitals. All coronary angiograms were carefully reviewed by two experts at a corelab to confirm the diagnosis of SCAD. In-hospital major adverse event (MAE) was defined as a composite of death, cardiogenic shock, myocardial re-infarction (MI), unplanned revascularization, ventricular arrhythmias (ventricular tachycardia or ventricular fibrillation) or stroke. A predefined 12-month major cardiovascular adverse event (MACE) was defined as a composite of death, MI, unplanned revascularization, SCAD recurrence or stroke. Results From June 2015 to December 2020, a total of 388 patients (440 lesions) with SCAD were included in the present analysis. Most patients were women (89%), with median age of 53 years old (IQR 47–60). Systemic hypertension (36%), hyperlipidemia (33%) and history of smoking habit (44%) were frequently seen in our cohort. Fifty-six percent of the patients included were postmenopausal. Peripartum context was rare (1.3%). Most patients presented as non-ST-segment-elevation myocardial infarction (NSTEMI) (55%) followed by ST-segment-elevation myocardial infarction (41%). Only 3% of the cohort presented as sudden cardiac death. Left anterior descending coronary artery was most frequently affected (44%), with SCAD lesions predominantly affecting distal (38%) segments and secondary branches (55%). Multivessel involvement was present in 11% of the patients. A long intramural hematoma (type 2 lesion) was the most ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/eurheartj/ehab724.1307 |
| Availability: |
https://doi.org/10.1093/eurheartj/ehab724.1307; https://academic.oup.com/eurheartj/article-pdf/42/Supplement_1/ehab724.1307/41053688/ehab724.1307.pdf |
| Rights: |
https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model |
| Accession Number: |
edsbas.56890B63 |
| Database: |
BASE |