Incidence and in-hospital mortality among women with acute myocardial infarction with or without SCAD

Curr Probl Cardiol. 2025 Jan;50(1):102921. doi: 10.1016/j.cpcardiol.2024.102921. Epub 2024 Nov 9.

Abstract

Background: Spontaneous coronary artery dissection (SCAD) has been increasingly recognized in the past decades. SCAD patients can present with acute myocardial infarction (AMI), particularly in young healthy women without conventional risk factors. However, data on the outcomes of SCAD patients presenting with AMI or benefit of PCI for SCAD in the setting of AMI is inconclusive.

Methods: We evaluated the prevalence, recent trends, the incidence and in-hospital mortality among women with acute myocardial infarction (AMI) who presented with or without SCAD, and to evaluate the impact of PCI on in-hospital mortality from a population-based analysis, using the National Inpatient Sample (NIS) database between 2016 and 2019.

Results: From 2016-2019, there were 1,527,555 cases of females presenting with AMI. Of that number, there were 12,125 cases of SCAD. Mortality trends in the SCAD and non-SCAD group were comparable. There was a gradual increase in incidence each year for SCAD-STEMI.

Conclusion: Mortality did not differ from 2016-2019 in patients with MI found to have SCAD or not. However, it seems that the SCAD-MI cases are gradually increasing each year. More research needs to be performed to better elucidate treatment outcomes in these patients.

Keywords: ACS; AMI; PCI; SCAD.

MeSH terms

  • Adult
  • Aged
  • Coronary Vessel Anomalies* / complications
  • Coronary Vessel Anomalies* / diagnosis
  • Coronary Vessel Anomalies* / epidemiology
  • Coronary Vessel Anomalies* / mortality
  • Female
  • Hospital Mortality* / trends
  • Humans
  • Incidence
  • Middle Aged
  • Myocardial Infarction* / epidemiology
  • Myocardial Infarction* / mortality
  • Percutaneous Coronary Intervention / methods
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • United States / epidemiology

Supplementary concepts

  • Coronary Artery Dissection, Spontaneous