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. 2022 Apr 22:15:100135.
doi: 10.1016/j.ahjo.2022.100135. eCollection 2022 Mar.

The presence of thrombus in spontaneous coronary artery dissection: A systematic review of autopsy findings

Vita N Jaspan  1 , Amy V Rapkiewicz  2 , Harmony R Reynolds  1
Affiliations

The presence of thrombus in spontaneous coronary artery dissection: A systematic review of autopsy findings

Vita N Jaspan et al. Am Heart J Plus. .

Abstract

Background: Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome in young women. There is no consensus on optimal treatment, though a conservative approach including antiplatelet agents is commonly used. We hypothesized that most cases of SCAD would not demonstrate true lumen thrombus in the dissected artery, suggesting that anti-platelet agents might not have a role in the treatment of SCAD.

Methods: We conducted a systematic review of the published literature through March 2022 to identify pathology images from individuals who died of SCAD. The images were independently reviewed by a pathologist to assess for the presence of thrombus and inflammatory cells.

Results: We identified 40 cases from 34 publications with available pathology images and found only one case of true lumen thrombus. Additionally, we found that 53% of cases involved eosinophilic inflammation.

Conclusion: The role of antiplatelet agents in the treatment of SCAD should be re-evaluated. Further studies are needed to better understand the significance and treatment implications of eosinophilic inflammation.

Keywords: Anti-platelet; SCAD; Spontaneous coronary artery dissection.

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Conflict of interest statement

Vita Jaspan and Amy Rapkiewicz have no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Harmony Reynolds receives non-financial support from Abbott Vascular, SIEMENS, and BioTelemetry Inc.

Figures

Fig. 1
Fig. 1
Record selection for systematic review.
Fig. 2
Fig. 2
Autopsy findings of fatal cases of SCAD.
See this image and copyright information in PMC

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References

    1. Saw J., Aymong E., Mancini G.B.J., Sedlak T., Starovoytov A., Ricci D. Nonatherosclerotic coronary artery disease in young women. Can. J. Cardiol. 2014;30:814–819. - PubMed
    1. Saw J., Mancini G.B.J., Humphries Karin H. Contemporary review on spontaneous coronary artery dissection. J. Am. Coll. Cardiol. 2016;68:297–312. - PubMed
    1. Hayes S.N., Tweet M.S., Adlam D., Kim E.S.H., Gulati R., Price J.E., Rose C.H. Spontaneous coronary artery dissection: JACC state-of-the-art review. J. Am. Coll. Cardiol. 2020;76:961–984. - PubMed
    1. Pitliya A., Datta S., Kalayci A., Kahe F., Sharfaei S., Jafarizade M., Goudarzi S., Chi G. Eosinophilic inflammation in spontaneous coronary artery dissection: a potential therapeutic target? Med. Hypotheses. 2018;121:91–94. - PubMed
    1. Brodsky S.V., Ramaswamy G., Chander P., Braun A. Ruptured cerebral aneurysm and acute coronary artery dissection in the setting of multivascular fibromuscular dysplasia: a case report. Angiology. 2007;58:764–767. - PubMed

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