Coronary Angiographic Manifestations and Outcomes in Spontaneous Coronary Artery Dissection Patients With and Without Fibromuscular Dysplasia

Inohara, Taku; Alfadhel, Mesfer; Choi, Dexter; Starovoytov, Andrew; Saw, Jacqueline

doi:10.1016/j.cjca.2021.08.019

Cited by 11 publications

(5 citation statements)

References 24 publications

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“…However, the study did not find a correlation between this gene locus and recurrent SCAD, possibly due to the modest sample size [25]. In line with this result, Inohara et al [26] did not find higher recurrent SCAD events in patients with FMD compared with those without FMD. Similarly, the study by Saw et al [7] reported that FMD was not a predictor of recurrent SCAD.…”

Section: Discussionmentioning

confidence: 84%

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Factors associated with recurrent spontaneous coronary artery dissection: a systematic review and meta-analysis

Chi

Najafi

Montazerin

et al. 2022

Coronary Artery Disease

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BackgroundThe risk of recurrent spontaneous coronary artery dissection (SCAD) is a major concern to SCAD patients and clinicians. Identifying the high-risk subsets of recurrent SCAD remains an ongoing challenge. The meta-analysis aimed to assess the potential predictors for SCAD recurrence. Methods A literature search was performed in PubMed to collect studies that assessed potential factors associated with recurrence of SCAD among angiographically confirmed SCAD patients, including pregnancy, ventricular arrhythmia at presentation, history of hypertension, migraine, fibromuscular dysplasia (FMD), extracoronary vascular abnormalities (EVA), recent emotional or physical stress, and use of thienopyridine, beta-blocker, or statin. A meta-analytic approach was employed to estimate the relative risk (RR) with a 95% confidence interval (CI) by fitting random-effects models using the generic inverse variance weighted method. ResultsA total of 14 studies representing 4206 SCAD patients were included. Hypertension (RR, 1.49; 95% CI, 1.05-2.12; P = 0.0247) and FMD (RR, 2.02; 95% CI, 1.03-3.94; P = 0.0404) were associated with a greater risk of SCAD recurrence. The use of beta-blocker (RR, 0.51; 95% CI, 0.33-0.77; P = 0.0013) was associated with a lower risk of SCAD recurrence. Pregnancy, ventricular arrhythmia at presentation, migraine, EVA, recent emotional or physical stress, and use of thienopyridine or statin were not significantly associated with recurrent SCAD (P > 0.05).Conclusion SCAD patients with hypertension or FMD were at a higher risk of recurrence, whereas beta-blocker usage was related to a reduced risk. These findings may provide insights into risk prediction and management after the SCAD episode.

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Section: Discussionmentioning

confidence: 84%

“…In line with this result, Inohara et al . [26] did not find higher recurrent SCAD events in patients with FMD compared with those without FMD. Similarly, the study by Saw et al .…”

Section: Discussionmentioning

confidence: 94%

Factors associated with recurrent spontaneous coronary artery dissection: a systematic review and meta-analysis

Chi

Najafi

Montazerin

et al. 2022

Coronary Artery Disease

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“…Since we reported the first case series of concomitant SCAD and extra‐coronary FMD in 2011 13 a high prevalence (72%–86%) of FMD has been observed in routinely screened SCAD cohorts 10 . The prevalence of extra‐coronary FMD in 346 patients from the CanSCAD cohort who had completed screening for renal, iliac and cerebral FMD was 72.3% 14 . Other causes of SCAD are much less frequent, but can include connective tissue disorders and systemic inflammatory diseases (Table 1).…”

Section: Disease Associations and Geneticsmentioning

confidence: 97%

“… 10 The prevalence of extra‐coronary FMD in 346 patients from the CanSCAD cohort who had completed screening for renal, iliac and cerebral FMD was 72.3%. 14 Other causes of SCAD are much less frequent, but can include connective tissue disorders and systemic inflammatory diseases (Table 1 ).…”

Section: Disease Associations and Geneticsmentioning

confidence: 99%

Spontaneous coronary artery dissection (SCAD): A contemporary review

Offen,

Yang,

Saw

2024

Clinical Cardiology

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Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction that most frequently affects younger women, making it an important cause of morbidity and mortality within these demographics. The evolution of intracoronary imaging, improved diagnosis with coronary angiography, and ongoing research efforts and attention via social media, has led to increasing recognition of this previously underdiagnosed condition. In this review, we provide a summary of the current body of knowledge, as well as focused updates on the pathogenesis of SCAD, insights on genetic susceptibility, contemporary diagnostic tools, and immediate, short‐ and long‐term management.

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“…The diameter of a dilated segment of an artery is 1.5 times greater. (5). In any case, many investigations have advocated that connective tissue, congenital, and inflammatory disorders are possible etiologies and that the process of atherosclerosis is the underlying driver in the maximum number of cases.…”

Section: Introductionmentioning

confidence: 99%

Angiographic Features of Patients With Coronary Artery Ectasia Compared With Stenotic Coronary Artery Disease

ULLAH,

HUSSAIN

2024

Biol Clin Sci Res J

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Coronary artery ectasia (CAE) and coronary artery stenotic disease (CASD) represent distinct pathologies of the coronary arteries with remarkable clinical and angiographic features. Objectives: The study aims to find the angiographic features of patients with coronary artery ectasia compared with stenotic coronary artery disease. Methods: This retrospective study was conducted at Prime Teaching Hospital Peshawar from April 2023 to March 2024. Data were collected from 185 patients. Patients with a history of coronary artery bypass grafting or coronary intervention were excluded from the study. Baseline demographic and clinical characteristics, including age, gender, cardiovascular risk factors, hypertension, diabetes mellitus, hyperlipidemia, smoking history and presenting symptoms, were collected from electronic medical records. Results: Data were collected from 185 patients. The mean age of patients in the CAE group was 58.5 ± 8.3 years, and the CAD group was 63.2 ± 7.9 years. 55.6% of the male group was in CAE and 87% in the CAD group. Out of 185, 33% suffered from hypertension in CAE and 81.4% in the CAD group. The most common comorbidity was hyperlipidemia in the CAD group (72.9%). Stable angina was present in 44.4% of CAE and 60.7% of the CAD group. Unstable angina is most common in the CAD group (21.4%), and AMI was 10.7% and 11.1% in the CAD and CAE groups, respectively. Percutaneous Coronary Intervention (PCI) was most common in the CAD group, which was 75%. Conclusion: It is concluded that coronary artery ectasia (CAE) presents distinct angiographic and clinical features compared to stenotic coronary artery disease (CAD), including localised or diffuse dilatation of coronary arteries, a higher prevalence of silent ischemia, and lower utilisation of percutaneous coronary intervention (PCI).

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Coronary Angiographic Manifestations and Outcomes in Spontaneous Coronary Artery Dissection Patients With and Without Fibromuscular Dysplasia

Cited by 11 publications

References 24 publications

Factors associated with recurrent spontaneous coronary artery dissection: a systematic review and meta-analysis

Factors associated with recurrent spontaneous coronary artery dissection: a systematic review and meta-analysis

Spontaneous coronary artery dissection (SCAD): A contemporary review

Angiographic Features of Patients With Coronary Artery Ectasia Compared With Stenotic Coronary Artery Disease

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