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. 2017 Jul 5;130(13):1534-1539.
doi: 10.4103/0366-6999.208245.

Spontaneous Coronary Artery Dissection as a Cause of Acute Myocardial Infarction in Young Female Population: A Single-center Study

Pei-Na Meng  1 , Chen Xu  1 , Wei You  1 , Zhi-Ming Wu  1 , Du-Jiang Xie  1 , Hang Zhang  1 , Chang Pan  1 , Fei Ye  1
Affiliations

Spontaneous Coronary Artery Dissection as a Cause of Acute Myocardial Infarction in Young Female Population: A Single-center Study

Pei-Na Meng et al. Chin Med J (Engl). .

Abstract

Background: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic but a rare and extremely dangerous clinical entity, it has a high prevalence in young female population with acute myocardial infarction (AMI). The previous reports were restricted to other countries' population, but rare in China. Hence, this study aimed to focus on the characteristics of SCAD as a cause of young female AMI population in Jiangsu, China.

Methods: This study enrolled young female AMI patients aged ≤50 years who underwent coronary angiography (CAG) and intracoronary imaging in our center between January 2013 and December 2016. Their clinical presentations, risk factors, and CAG characteristics were analyzed.

Results: A total of 60 young female AMI (<7 days) patients were enrolled. From their CAG and intracoronary imaging results, the prevalence of SCAD in young female AMI population was 35% (21/60), the prevalence of coronary atherosclerostic heart disease was 65% (39/60). In the SCAD group, 43% (9/21) presented with non-ST-elevation myocardial infarction (NSTEMI) and the remainder presenting as STEMI. SCAD usually occurred in a single vessel (20/21, 95%), especially in left anterior descending artery (14/21, 67%). Eighteen patients (18/21, 86%) underwent conservative treatment, whereas the remaining three patients (3/21, 14%) underwent percutaneous coronary intervention. Regarding the angiographic results of SCAD lesions, intramural hematoma was discriminated in 95% (20/21), and Type I imaging was observed in 5% (1/21), Type II was observed in 67% (14/21), and Type III was 29% (6/21). The average stenosis in the group was 76.9% ± 20.6%, and the mean lesion length was 36.6 ± 8.6 mm.

Conclusions: SCAD has a high prevalence in young female AMI population in Jiangsu, China. Discriminating the cause of AMI in young female population is very important.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Type I: Multiple radiolucent lumens of the coronary arterial wall with contrast staining in the left anterior descending.
Figure 2
Figure 2
Type II: Diffused stenosis but smoothly narrowing in the mid to distal segment of left anterior descending.
Figure 3
Figure 3
The true and false lumens from optical coherence tomography result which located at the frame from Figure 2.
Figure 4
Figure 4
Type III: Mimic atherosclerosis, hazy or linear stenosis but lack of atherosclerotic changes in other coronary arteries.
Figure 5
Figure 5
The true and false lumens from optical coherence tomography result which located at the frame from Figure 4.
See this image and copyright information in PMC

References

    1. Vrints CJ. Spontaneous coronary artery dissection. Heart. 2010;96:801–8. doi: 10.1136/hrt.2008.162073. - PubMed
    1. Pretty HC. Dissecting aneurysm of coronary artery in a woman aged 42: Rupture. BMJ. 1931;1:667.
    1. Saw J, Poulter R, Fung A, Wood D, Hamburger J, Buller CE. Spontaneous coronary artery dissection in patients with fibromuscular dysplasia: A case series. Circ Cardiovasc Interv. 2012;5:134–7. doi: 10.1161/CIRCINTERVENTIONS.111.966630. - PubMed
    1. Saw J, Ricci D, Starovoytov A, Fox R, Buller CE. Spontaneous coronary artery dissection: Prevalence of predisposing conditions including fibromuscular dysplasia in a tertiary center cohort. JACC Cardiovasc Interv. 2013;6:44–52. doi: 10.1016/j.jcin.2012.08.017. - PubMed
    1. Tweet MS, Hayes SN, Pitta SR, Simari RD, Lerman A, Lennon RJ, et al. Clinical features, management, and prognosis of spontaneous coronary artery dissection. Circulation. 2012;126:579–88. doi: 10.1161/CIRCULATIONAHA.112.1058718. - PubMed

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Supplementary concepts