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Spontaneous coronary artery dissection (SCAD) is an emerging cause of myocardial infarction in younger women. There are known associations between SCAD and extracoronary vascular abnormalities (EVA) such as fibromuscular dysplasia (FMD), aneurysm, pseudoaneurysm, and dissection, but differences in patient characteristics between those with and without EVA are ill-defined. It is also unknown whether the presence of EVA is associated with SCAD recurrence.
Medical records of patients seen in a dedicated SCAD clinic were reviewed. All patients were screened for EVA with head to pelvis CTA. Baseline characteristics, SCAD presentation, lab and imaging results, and recurrent SCAD events were recorded. Patient characteristics and recurrent SCAD events were stratified by presence of EVA and assessed.
104 SCAD patients were identified from 6/2016 to 9/2019. Mean age (SD) was 51.0 (9.8) years, 96.2% were female, and 50.0% had EVA. 44.2% (46/104) of patients had FMD, 14.4% (15/104) aneurysm, 7.7% (8/104) pseudoaneurysm, and 8.7% (9/104) extracoronary dissection. 88.5% (46/52) of EVA were FMD lesions. Those with EVA had higher rates of SCAD recurrence (25.0% (13/52) vs 5.8% (3/52), p=.007). There were no significant differences in age, SCAD presentation, vessel involvement, or atherosclerotic risk factors between those with and without EVA.
EVA, particularly FMD, are common in patients with SCAD. The presence of EVA is associated with higher rates of SCAD recurrence.
Sunday, March 29, 2020, 9:04 a.m.-9:14 a.m.
Session Title: Highlighted Original Research: Vascular Medicine and the Year in Review
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 906-12
- 2020 American College of Cardiology Foundation