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Spontaneous coronary artery dissection in Spain: clinical and angiographic characteristics, management, and in-hospital events
- Source :
- Revista Española de Cardiología (English Edition). 74:15-23
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Introduction and objectives Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute coronary syndrome. The characteristics and in-hospital clinical course of patients with SCAD in Spain remain unknown. Methods We present data from consecutive patients included in the national prospective SCAD registry. Angiographic analysis was performed in a centralized core laboratory. Results Between June 2015 and April 2019, we included 318 patients with SCAD (358 lesions) from 31 centers. Median age was 53 years, and 88% were women. The most frequent presentation was non–ST-segment elevation acute myocardial infarction (53%). The most frequently involved artery was the left anterior descending coronary artery (44%), predominantly affecting the distal segments (39%) and secondary branches (54%). Most lesions (62%) appeared on angiography as intramural hematoma, without double lumen. Conservative management was selected as the initial approach in most patients (78%). During the index admission, 6% of patients had a major adverse event and 4 patients (1.3%) died. Independent predictors of adverse events were initial management with percutaneous coronary intervention (OR, 5.97; P = .004) and angiographic presentation as intramural hematoma (OR, 4.96; P = .028). Conclusions In Spain, SCAD affects mainly middle-aged women. In most patients, the initial management strategy was conservative with excellent in-hospital survival. Initial management with percutaneous coronary intervention and angiographic presentation as intramural hematoma were related to the presence of in-hospital adverse events. Registered at ClnicalTrials.gov (Identifier: NCT03607981).
- Subjects :
- Male
medicine.medical_specialty
Acute coronary syndrome
Coronary Vessel Anomalies
medicine.medical_treatment
Lumen (anatomy)
030204 cardiovascular system & hematology
Anterior Descending Coronary Artery
Coronary Angiography
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Prospective Studies
Myocardial infarction
medicine.diagnostic_test
business.industry
Dissection
Percutaneous coronary intervention
General Medicine
Middle Aged
medicine.disease
Coronary Vessels
Hospitals
Surgery
Spain
Angiography
Female
Scad
business
Subjects
Details
- ISSN :
- 18855857
- Volume :
- 74
- Database :
- OpenAIRE
- Journal :
- Revista Española de Cardiología (English Edition)
- Accession number :
- edsair.doi.dedup.....e260c12a2ad4ce2dc47913d5d0dce191