Author + information
- Rahul Potluri,
- Robert Welsh,
- Minh Vo and
- Kevin Bainey
Introduction: Spontaneous coronary artery dissection (SCAD) is recognised presentation of ACS. Using a large UK registry, we examined the incidence, demographics and long-term survival of ACS patients with SCAD.
Methods: We compared ACS patients with SCAD versus without SCAD admitted to hospitals in the UK (2000-2014) from the Algorithm for Co-morbidity, Associations, Length of stay and Mortality (ACALM) registry (n=33, 163). ACALM collects ICD-10 and OPCS-4 codes to identify patient data. Primary outcome was all-cause mortality (14-year time period). Adjustment was performed using a Cox-regression model.
Results: In our cohort, 182 patients (0.54%) were diagnosed with SCAD as the cause for ACS. Patients were were younger, more likely female and less risk factors or comorbid conditions (Table). Revascularization with PCI or CABG was uncommon (11.0%, 2.7% respectively). All-cause mortality was significantly better in SCAD(10.4% vs. 32.1%, p=0.003). KM curve is shown (Figure). After adjusting for age, gender, ethnic group and comorbidites, improved survival was observed (OR 1.89; 95%CI 1.20-2.96).
Conclusions: In this large UK registry, a minority present with SCAD. Patients are commonly younger females without risk factors. This is the first study to demonstrate improved long-term survival with SCAD. Our analysis suggests conservative therapy is a safe option. Further studies are required to explore non-traditional risk factors, predictors of SCAD and best treatment strategy for these patients.
Room 150 A
Sunday, March 19, 2017, 8:51 a.m.-9:01 a.m.
Session Title: Highlighted Original Research: Acute and Stable Ischemic Heart Disease and the Year in Review
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 907-10
- 2017 American College of Cardiology Foundation