Spontaneous coronary artery dissection epidemiology and demographics
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Spontaneous Coronary Artery Dissection Microchapters |
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Differentiating Spontaneous coronary artery dissection from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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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
Based on the relatively limited data that is currently available, the estimated incidence of SCAD is approximately 800 new cases per year in the US.[1] 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 MI.[2] SCAD should be highly suspected in any young subject presenting with acute myocardial ischemia, but without traditional risk factors for coronary artery disease (CAD).The left anterior descending artery (LAD) is the most commonly affected artery.[3][4] Although multivessel SCAD has been reported, single vessel SCAD is much more common. In women LAD is frequently involved[3] 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[5] 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.[6][7][8] 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.[9]
The prevalence of each type of SCAD is as follows:[10]
- Type 1: <30%
- Type 2: approximately 66%
- Type 3: <5%
References
- ↑ 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. Unknown parameter
|month=ignored (help) - ↑ 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.
- ↑ 3.0 3.1 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
|month=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
|month=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
|month=ignored (help) - ↑ Narasimhan, S (2004). "Spontaneous coronary artery dissection (SCAD)" (PDF). IJTCVS. 20 (4): 189–91. doi:10.1007/s12055-004-0084-x.
- ↑ Zampieri P, Aggio S, Roncon L; et al. (1996). "Follow up after spontaneous coronary artery dissection: a report of five cases". Heart (British Cardiac Society). 75 (2): 206–9. PMC 484263. PMID 8673763. Unknown parameter
|month=ignored (help) - ↑ 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
|month=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) - ↑ Saw J (2014). "Coronary angiogram classification of spontaneous coronary artery dissection". Catheter Cardiovasc Interv. 84 (7): 1115–22. doi:10.1002/ccd.25293. PMID 24227590.