Author + information
- Maya Serhal,
- Ashok Mittal,
- Marianne Khoury,
- Ellen Brinza,
- Natalia Fendrikova-Mahlay,
- Heather Gornik and
- Esther Kim
Background: Spontaneous coronary dissection (SCAD) is an important cause of ACS in young women and is associated with fibromuscular dysplasia (FMD) in 45-72% of cases. ∼1/4 of FMD patients have a family history (FHx) of aneurysm, but FHx of arterial disorders among SCAD patients is not well described.
Methods: Medical records of patients enrolled in a prospective SCAD Registry were reviewed for self-reported 1st and 2nd degree FHx. All patients were seen by a FMD specialist from 8/2015-9/2016. FHx of arterial diseases were stratified by presence of FMD in the SCAD proband to determine if any differences in prevalence existed by co-existent FMD.
Results: Of 64 patients enrolled in the registry, 62 (95.3%) were screened for FMD from “head-to-pelvis” with CTA or MRA. Mean age at enrollment was 50.9 years; 100% were women. 17.2% (n=11) had more than one SCAD event. 27 patients (43.8 %) had FMD with the following distribution: 74.1% carotid, 51.9% renal, 29.6% vertebral, 18.6% mesenteric, 14.8% iliofemoral, and 11.1% intracranial. There was no significant difference in prevalence of FHx of aneurysm, dissection, early stroke, early MI by FMD in the SCAD proband (Table), though there was a trend for more FHx of aneurysms in those without FMD (p=0.07).
Conclusions: FHx of aneurysm, early stroke, and early MI is highly prevalent in SCAD patients, regardless of the presence of concomitant FMD. The clinical implications of this finding warrant further study. This suggests that SCAD is a manifestation of underlying arteriopathy.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Vascular Medicine: Emerging Concepts in Clinical Vascular Diseases
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1254-352
- 2017 American College of Cardiology Foundation