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. 2021 Jan;36(1):106-113.
doi: 10.3904/kjim.2019.118. Epub 2019 Jul 18.

Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea

Yongcheol Kim  1 , Xiongyi Han  1 , Youngkeun Ahn  1 , Min Chul Kim  1 , Doo Sun Sim  1 , Young Joon Hong  1 , Ju Han Kim  1 , Myung Ho Jeong  1
Affiliations

Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea

Yongcheol Kim et al. Korean J Intern Med. 2021 Jan.

Abstract

Background/aims: We aimed to evaluate the prevalence, characteristics, and clinical outcomes of spontaneous coronary artery dissection (SCAD) in young female patients with acute myocardial infarction (AMI).

Methods: We identified 8,250 patients diagnosed with AMI who underwent coronary angiogram from the Chonnam National University Hospital database, Gwangju, Korea, between November 2005 and September 2017. A total of 148 female patients aged less than 60 years with a history of AMI were retrospectively studied and the characteristics and clinical outcomes were evaluated for all SCAD patients.

Results: Among female patients with AMI aged less than 60 years, the prevalence of SCAD was 8.78% (13 of 148). Based on the angiographic classification, type 2 SCAD was most commonly observed on angiograms in 69.2% of the cases (nine of 13), followed by type 3 in 23.1% (three of 13), and type 1 in 7.7% (one of 13). Furthermore, the left anterior descending (LAD) artery was the most commonly affected coronary artery (76.9%, 10 of 13 cases) and the distal segments of the coronary arteries were the most common sites of SCAD (92.3%, 12 of 13). Regarding the clinical outcomes, one of 13 patients experienced repeat revascularization during the following 31 months.

Conclusion: The prevalence of SCAD was 8.7%, indicating that SCAD is not rare, among female patients aged less than 60 years with AMI in Korea. Type 2 SCAD was most commonly observed on angiogram. Moreover, the distal portion of the LAD was the segment most commonly affected by SCAD. The long-term clinical outcomes were favorable in patients surviving SCAD.

Keywords: Coronary artery disease; Dissection; Myocardial infarction; Prevalence; Prognosis.

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Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
Angiographic classification of spontaneous coronary artery dissection. (A) Patient no. 9: type I, arterial wall contrast staining (arrows) or multiple radiolucent lumens (arrowheads). (B) Patient no. 7: type 2a, abrupt caliber reduction (arrowheads) with restoration of distal vessel caliber (arrow). (C) Patient no. 13: type 2b, abrupt caliber reduction without restoration of distal vessel caliber (arrowheads). (D) Patient no. 5: type 3, tubular stenosis mimicking atherosclerosis (double-point arrow), and confirming false lumen (asterisks) by intravascular ultrasound (d).
Figure 2.
Figure 2.
Flow chart of the study patients. AMI, acute myocardial infarction; CAG, coronary angiogram.
Figure 3.
Figure 3.
Prevalence, type, and location of spontaneous coronary artery dissection. SCAD, spontaneous coronary artery dissection.
See this image and copyright information in PMC

Comment in

References

    1. Alfonso F, Bastante T. Spontaneous coronary artery dissection: novel diagnostic insights from large series of patients. Circ Cardiovasc Interv. 2014;7:638–641. - PubMed
    1. Vanzetto G, Berger-Coz E, Barone-Rochette G, et al. Prevalence, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection: results from a database of 11,605 patients. Eur J Cardiothorac Surg. 2009;35:250–254. - PubMed
    1. Nakashima T, Noguchi T, Haruta S, et al. Prognostic impact of spontaneous coronary artery dissection in young female patients with acute myocardial infarction: a report from the Angina Pectoris-Myocardial Infarction Multicenter Investigators in Japan. Int J Cardiol. 2016;207:341–348. - PubMed
    1. Rashid HN, Wong DT, Wijesekera H, et al. Incidence and characterisation of spontaneous coronary artery dissection as a cause of acute coronary syndrome: a single-centre Australian experience. Int J Cardiol. 2016;202:336–338. - PubMed
    1. Mortensen KH, Thuesen L, Kristensen IB, Christiansen EH. Spontaneous coronary artery dissection: a Western Denmark Heart Registry study. Catheter Cardiovasc Interv. 2009;74:710–717. - PubMed

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