Recurrent spontaneous coronary artery dissection in the United States

Int J Cardiol. 2020 Feb 15:301:34-37. doi: 10.1016/j.ijcard.2019.10.052. Epub 2019 Nov 13.

Abstract

Background: Recurrent spontaneous coronary artery dissection (SCAD) is believed to be infrequent. Predictors of recurrent SCAD are poorly characterized.

Methods: We evaluated the incidence, clinical characteristics, and predictors of recurrent SCAD using data from the Nationwide Readmissions Database from January 1, 2010, to December 30, 2016.

Results: Among 1836 SCAD patients admitted with the primary diagnosis of SCAD (61.9% female, mean age 56.1 ± 14.5, 72.9% <65 years of age), 495 patients (26.9%) had recurrent SCAD within 1 year (74.0% female, 74% <65 years of age). Multivariable analysis showed that female sex (OR 2.09; 95% CI 1.49-2.95; p < 0.001) was an independent predictor of recurrent SCAD within 1 year.

Conclusions: Recurrent SCAD is frequent and should be considered in younger females with a history of SCAD. Further research is needed to investigate the mechanistic links between female sex and recurrent SCAD.

Keywords: Recurrent spontaneous coronary artery dissection; SCAD; Spontaneous coronary artery dissection.

MeSH terms

  • Age Factors
  • Coronary Angiography* / methods
  • Coronary Angiography* / statistics & numerical data
  • Coronary Vessel Anomalies* / diagnosis
  • Coronary Vessel Anomalies* / epidemiology
  • Coronary Vessel Anomalies* / therapy
  • Coronary Vessels / diagnostic imaging*
  • Databases, Factual / statistics & numerical data
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data*
  • Prognosis
  • Recurrence
  • Risk Factors
  • Sex Factors
  • United States / epidemiology
  • Vascular Diseases / congenital*
  • Vascular Diseases / diagnosis
  • Vascular Diseases / epidemiology
  • Vascular Diseases / therapy

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous