Spontaneous coronary artery dissection epidemiology and demographics
Spontaneous Coronary Artery Dissection Microchapters |
Differentiating Spontaneous coronary artery dissection from other Diseases |
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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 and is estimated at 200 per 100,000 persons (0.2%) in the whole population (men: 0.1%, women: 0.6%). The prevalence of SCAD is approximately 8.7% and 10.8% in women <50 years with acute coronary syndrome (ACS) and ST elevation-ACS, respectively.[1]
Incidence
The population-based incidence of SCAD remains unknown. Retrospective angiographic registries have reported SCAD detection in 0.1 to 1.1% of all coronary angiograms performed.[2][3][4][5][6][7][8] In the United States, there are approximately 800 new cases of SCAD occur every year.[9][10]
Case Fatality Rate
In-hospital mortality of SCAD is relatively low with an estimated rate of 0 to 4%.[1]
Age
Gender
SCAD has a strong predilection for young women with no or minimal traditional atherosclerotic risk factors. Studies indicate that SCAD accounts for approximately 25% of women aged < 50 who present with myocardial infarction.[11]
Race
The left anterior descending artery (LAD) is the most commonly affected artery.[12][13] Although multivessel SCAD has been reported, single vessel SCAD is much more common. In women LAD is frequently involved[12] while in men right coronary artery is involved more often. Men tend to present at a slightly later age and also with evidence of CAD risk factors.
Observational studies have reported that SCAD is common among young women during their peripartum period[14] or in association with use of oral contraceptives. About 80% of SCAD cases reported so far have occurred in young women, especially those taking oral contraceptives (OCPs) or those in the peripartum period.[15][7][16] Possible mechanisms underlying increased prevalence of SCAD in this population include: changes in the arterial wall media due to increasing hormone levels, shear stress during labor, fragmentation of reticulin fibers, loosening of ground substance, and hypertrophy of smooth muscle.[17]
References
- ↑ 1.0 1.1 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 7.0 7.1 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 12.0 12.1 Vanzetto G, Berger-Coz E, Barone-Rochette G; et al. (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 : Official Journal of the European Association for Cardio-thoracic Surgery. 35 (2): 250–4. doi:10.1016/j.ejcts.2008.10.023. PMID 19046896. Unknown parameter
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ignored (help) - ↑ Kamran M, Guptan A, Bogal M (2008). "Spontaneous coronary artery dissection: case series and review". J Invasive Cardiol. 20 (10): 553–9. PMID 18830003. Unknown parameter
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ignored (help) - ↑ 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. Unknown parameter
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ignored (help) - ↑ Narasimhan, S (2004). "Spontaneous coronary artery dissection (SCAD)" (PDF). IJTCVS. 20 (4): 189–91. doi:10.1007/s12055-004-0084-x.
- ↑ 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. Unknown parameter
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ignored (help) - ↑ 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. Unknown parameter
|month=
ignored (help)