Spontaneous coronary artery dissection epidemiology and demographics: Difference between revisions

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===Gender===
===Gender===


SCAD has a strong predilection for young women with no or minimal traditional cardiovascular risk factors.  It has been reported that SCAD is the most common non-atherosclerotic [[coronary artery disease]] in women <50 years of age and accounts for 24% of [[myocardial infarctions]].<ref name="pmid24726091">{{cite journal| author=Saw J, Aymong E, Mancini GB, Sedlak T, Starovoytov A, Ricci D| title=Nonatherosclerotic coronary artery disease in young women. | journal=Can J Cardiol | year= 2014 | volume= 30 | issue= 7 | pages= 814-9 | pmid=24726091 | doi=10.1016/j.cjca.2014.01.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24726091}}</ref>  The risk of SCAD has been associated with [[pregnancy]] as well as the use of [[oral contraceptives]].<ref name="pmid19708230">{{cite journal |author=Fontanelli A, Olivari Z, La Vecchia L, ''et al.'' |title=Spontaneous dissections of coronary arteries and acute coronary syndromes: rationale and design of the DISCOVERY, a multicenter prospective registry with a case-control group |journal=[[Journal of Cardiovascular Medicine (Hagerstown, Md.)]] |volume=10 |issue=1 |pages=94–9 |year=2009 |pmid=19708230 |doi= |url=}}</ref><ref name="Narasimhan2004">{{cite journal|last1=Narasimhan|first1=Seshasayee|title=Spontaneous coronary artery dissection (SCAD)|journal=Indian Journal of Thoracic and Cardiovascular Surgery|volume=20|issue=4|year=2004|pages=189–191|issn=0970-9134|doi=10.1007/s12055-004-0084-x}}</ref><ref name="pmid10700066">{{cite journal |author=Cohen DE, Strimike CL|title=A case of multiple spontaneous coronary artery dissections |journal=[[Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions]] |volume=49 |issue=3 |pages=318–20 |year=2000 |pmid=10700066 |doi= |url=}}</ref>  Possible mechanisms underlying increased prevalence of SCAD in this population include: alterations in the arterial wall media secondary to hormonal change, shear stress during labor, fragmentation of reticulin fibers, loosening of ground substance, and hypertrophy of smooth muscle.<ref name="pmid19127318">{{cite journal |author=Van den Branden BJ, Bruggeling WA, Corbeij HM, Dunselman PH |title=Spontaneous coronary artery dissection in the postpartum period |journal=Neth Heart J |volume=16 |issue=12 |pages=412–4 |year=2008|pmid=19127318 |pmc=2612109 |doi= |url=}}</ref>
SCAD has a strong predilection for young women with no or minimal traditional cardiovascular risk factors.  It has been reported that SCAD is the most common non-atherosclerotic [[coronary artery disease]] in women <50 years of age and accounts for 24% of [[myocardial infarctions]].<ref name="pmid24726091">{{cite journal| author=Saw J, Aymong E, Mancini GB, Sedlak T, Starovoytov A, Ricci D| title=Nonatherosclerotic coronary artery disease in young women. | journal=Can J Cardiol | year= 2014 | volume= 30 | issue= 7 | pages= 814-9 | pmid=24726091 | doi=10.1016/j.cjca.2014.01.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24726091}}</ref>  The risk of SCAD has been associated with [[pregnancy]] as well as the use of [[oral contraceptives]].<ref name="pmid19708230">{{cite journal |author=Fontanelli A, Olivari Z, La Vecchia L, ''et al.'' |title=Spontaneous dissections of coronary arteries and acute coronary syndromes: rationale and design of the DISCOVERY, a multicenter prospective registry with a case-control group |journal=[[Journal of Cardiovascular Medicine (Hagerstown, Md.)]] |volume=10 |issue=1 |pages=94–9 |year=2009 |pmid=19708230 |doi= |url=}}</ref><ref name="Narasimhan2004">{{cite journal|last1=Narasimhan|first1=Seshasayee|title=Spontaneous coronary artery dissection (SCAD)|journal=Indian Journal of Thoracic and Cardiovascular Surgery|volume=20|issue=4|year=2004|pages=189–191|issn=0970-9134|doi=10.1007/s12055-004-0084-x}}</ref><ref name="pmid10700066">{{cite journal |author=Cohen DE, Strimike CL|title=A case of multiple spontaneous coronary artery dissections |journal=[[Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions]] |volume=49 |issue=3 |pages=318–20 |year=2000 |pmid=10700066 |doi= |url=}}</ref>  Possible mechanisms underlying increased prevalence of SCAD in this population include structural alterations in the arterial wall secondary to hormonal change, increased shear stress during [[labor]], fragmentation of [[reticulin|reticulin fibers]], loosening of [[ground substance]], and [[hypertrophy]] of smooth muscle.<ref name="pmid19127318">{{cite journal |author=Van den Branden BJ, Bruggeling WA, Corbeij HM, Dunselman PH |title=Spontaneous coronary artery dissection in the postpartum period |journal=Neth Heart J |volume=16 |issue=12 |pages=412–4 |year=2008|pmid=19127318 |pmc=2612109 |doi= |url=}}</ref>


==References==
==References==

Revision as of 23:11, 1 December 2017

Spontaneous Coronary Artery Dissection Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Spontaneous coronary artery dissection from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Approach

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Angiography

CT

MRI

Echocardiography

Other Imaging Findings

Other Diagnostic Studies

Treatment

Treatment Approach

Medical Therapy

Percutaneous Coronary Intervention

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Type 1

Type 2A

Type 2B

Type 3

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Synonyms and keywords: SCAD

Overview

Epidemiology and Demographics

Prevalence

The true prevalence of spontaneous coronary artery dissection (SCAD) remains unknown. The prevalence of SCAD is estimated at 0.2% in the whole population, 8.7% in women <50 years with acute coronary syndrome (ACS), and 10.8% in women <50 years with ST elevation-ACS.[1]

Incidence

The annual incidence of SCAD is estimated at 0.26 per 100,000 persons (0.33 in women and 0.18 in men), corresponding to 800 new cases of SCAD per year in the United States.[2] Retrospective angiographic registries have reported SCAD detection in approximately 0.1 to 1.1% of all coronary angiograms performed.[3][4][5][6][7][8][9][10]

Case Fatality Rate

The case fatality rate of SCAD is relatively low compared with other causes of ACS, with an estimated in-hospital mortality rate of 0 to 4%.[1]

Age

The prevalence of SCAD decreases with age, and is estimated at 7.6%, 4.0%, 2.1%, and 1.2% in women below the age of 40, 50, 60, and 70, respectively.[1]

Gender

SCAD has a strong predilection for young women with no or minimal traditional cardiovascular risk factors. It has been reported that SCAD is the most common non-atherosclerotic coronary artery disease in women <50 years of age and accounts for 24% of myocardial infarctions.[11] The risk of SCAD has been associated with pregnancy as well as the use of oral contraceptives.[12][13][14] Possible mechanisms underlying increased prevalence of SCAD in this population include structural alterations in the arterial wall secondary to hormonal change, increased shear stress during labor, fragmentation of reticulin fibers, loosening of ground substance, and hypertrophy of smooth muscle.[15]

References

  1. ↑ 1.0 1.1 1.2 Vanzetto, Gerald; Berger-Coz, Estelle; Barone-Rochette, Gilles; Chavanon, Olivier; Bouvaist, Helene; Hacini, Rachid; Blin, Dominique; Machecourt, Jacques (2009). "Prevalence, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection: results from a database of 11,605 patients". European Journal of Cardio-Thoracic Surgery. 35 (2): 250–254. doi:10.1016/j.ejcts.2008.10.023. ISSN 1010-7940.
  2. ↑ Tweet, MS.; Hayes, SN.; Pitta, SR.; Simari, RD.; Lerman, A.; Lennon, RJ.; Gersh, BJ.; Khambatta, S.; Best, PJ. (2012). "Clinical features, management, and prognosis of spontaneous coronary artery dissection". Circulation. 126 (5): 579–88. doi:10.1161/CIRCULATIONAHA.112.105718. PMID 22800851.
  3. ↑ Celik SK, Sagcan A, Altintig A, Yuksel M, Akin M, Kultursay H (2001). "Primary spontaneous coronary artery dissections in atherosclerotic patients. Report of nine cases with review of the pertinent literature". Eur J Cardiothorac Surg. 20 (3): 573–6. PMID 11509281.
  4. ↑ Alfonso, Fernando; Paulo, Manuel; Lennie, Vera; Dutary, Jaime; Bernardo, Esther; Jiménez-Quevedo, Pilar; Gonzalo, Nieves; Escaned, Javier; Bañuelos, Camino; Pérez-Vizcayno, María J.; Hernández, Rosana; Macaya, Carlos (2012). "Spontaneous Coronary Artery Dissection". JACC: Cardiovascular Interventions. 5 (10): 1062–1070. doi:10.1016/j.jcin.2012.06.014. ISSN 1936-8798.
  5. ↑ Mortensen, K.H.; Thuesen, L.; Kristensen, I.B.; Christiansen, E.H. (2009). "Spontaneous coronary artery dissection: A Western Denmark Heart Registry Study". Catheterization and Cardiovascular Interventions. 74 (5): 710–717. doi:10.1002/ccd.22115. ISSN 1522-1946.
  6. ↑ Pasalodos Pita J, Vazquez Gonzalez N, Perez Alvarez L, Vazquez Rodriguez JM, Castro Beiras A (1994). "Spontaneous coronary artery dissection". Cathet Cardiovasc Diagn. 32 (1): 27–32. PMID 8039214.
  7. ↑ Jorgensen MB, Aharonian V, Mansukhani P, Mahrer PR (1994). "Spontaneous coronary dissection: a cluster of cases with this rare finding". Am. Heart J. 127 (5): 1382–7. PMID 8172069.
  8. ↑ Zampieri P, Aggio S, Roncon L, Rinuncini M, Canova C, Zanazzi G, Fiorencis R, Zonzin P (1996). "Follow up after spontaneous coronary artery dissection: a report of five cases". Heart. 75 (2): 206–9. PMC 484263. PMID 8673763.
  9. ↑ Hering D, Piper C, Hohmann C, Schultheiss HP, Horstkotte D (1998). "[Prospective study of the incidence, pathogenesis and therapy of spontaneous, by coronary angiography diagnosed coronary artery dissection]". Z Kardiol (in German). 87 (12): 961–70. PMID 10025069.
  10. ↑ Adams, Heath; Paratz, Elizabeth; Somaratne, Jithendra; Layland, Jamie; Burns, Andrew; Palmer, Sonny; MacIsaac, Andrew; Whitbourn, Robert (2017). "Different patients, different outcomes: A case-control study of spontaneous coronary artery dissection versus acute coronary syndrome". Journal of Interventional Cardiology. doi:10.1111/joic.12447. ISSN 0896-4327.
  11. ↑ Saw J, Aymong E, Mancini GB, Sedlak T, Starovoytov A, Ricci D (2014). "Nonatherosclerotic coronary artery disease in young women". Can J Cardiol. 30 (7): 814–9. doi:10.1016/j.cjca.2014.01.011. PMID 24726091.
  12. ↑ Fontanelli A, Olivari Z, La Vecchia L; et al. (2009). "Spontaneous dissections of coronary arteries and acute coronary syndromes: rationale and design of the DISCOVERY, a multicenter prospective registry with a case-control group". Journal of Cardiovascular Medicine (Hagerstown, Md.). 10 (1): 94–9. PMID 19708230.
  13. ↑ Narasimhan, Seshasayee (2004). "Spontaneous coronary artery dissection (SCAD)". Indian Journal of Thoracic and Cardiovascular Surgery. 20 (4): 189–191. doi:10.1007/s12055-004-0084-x. ISSN 0970-9134.
  14. ↑ Cohen DE, Strimike CL (2000). "A case of multiple spontaneous coronary artery dissections". Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 49 (3): 318–20. PMID 10700066.
  15. ↑ Van den Branden BJ, Bruggeling WA, Corbeij HM, Dunselman PH (2008). "Spontaneous coronary artery dissection in the postpartum period". Neth Heart J. 16 (12): 412–4. PMC 2612109. PMID 19127318.
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