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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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A. Arzu Kalayci, M.D. [2]
Synonyms and keywords: SCAD
Overview
The annual incidence of spontaneous coronary artery dissection is estimated at 0.26 per 100,000 persons (0.33 in women and 0.18 in men), corresponding to approximately 800 new cases per year in the United States. The true prevalence of spontaneous coronary artery dissection in the general population remains unknown; however, retrospective angiographic registries have reported a SCAD detection rate of 0.1 to 1.1% among all coronary angiograms performed.
Epidemiology and Demographics
Prevalence
The true prevalence of spontaneous coronary artery dissection (SCAD) remains unknown. The prevalence from a prospective interventional cardiology laboratory database was estimated at 0.2% in the study population, 8.7% in women <50 years with acute coronary syndrome (ACS), and 10.8% in women <50 years with ST elevation ACS.[1] Retrospective angiographic registries have reported a SCAD detection rate of 0.1 to 1.1% among all coronary angiograms performed.[2][3][4][5][6][7][8][9]
Incidence
The annual incidence of SCAD is estimated at 0.26 per 100,000 persons (0.33 in women and 0.18 in men), corresponding to approximately 800 new cases per year in the United States.[10]
Case Fatality Rate
The case fatality rate of SCAD is relatively low compared with other causes of ACS, with an estimated in-hospital mortality rate of 0 to 4%.[1]
Age
The prevalence of SCAD decreases with age, and is estimated at 7.6%, 4.0%, 2.1%, and 1.2% in women below the age of 40, 50, 60, and 70, respectively.[1]
Gender
SCAD has a strong predilection for young women with no or minimal traditional cardiovascular risk factors. SCAD is one of the most common non-atherosclerotic coronary artery diseases in women <50 years of age and accounts for one-fourth of myocardial infarctions.[11] The risk of SCAD has been associated with pregnancy as well as the use of oral contraceptives.[12][13][14] Possible mechanisms underlying increased prevalence of SCAD in this population include structural alterations in the arterial wall secondary to hormonal change, increased shear stress during labor, fragmentation of reticulin fibers, loosening of ground substance, and hypertrophy of smooth muscle.[15]
Race
There is limited information regarding the race and ethnicity of patients with SCAD.
References
- ↑ 1.0 1.1 1.2 Vanzetto, Gerald; Berger-Coz, Estelle; Barone-Rochette, Gilles; Chavanon, Olivier; Bouvaist, Helene; Hacini, Rachid; Blin, Dominique; Machecourt, Jacques (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. 35 (2): 250–254. doi:10.1016/j.ejcts.2008.10.023. ISSN 1010-7940.
- ↑ Celik SK, Sagcan A, Altintig A, Yuksel M, Akin M, Kultursay H (2001). "Primary spontaneous coronary artery dissections in atherosclerotic patients. Report of nine cases with review of the pertinent literature". Eur J Cardiothorac Surg. 20 (3): 573–6. PMID 11509281.
- ↑ Alfonso, Fernando; Paulo, Manuel; Lennie, Vera; Dutary, Jaime; Bernardo, Esther; Jiménez-Quevedo, Pilar; Gonzalo, Nieves; Escaned, Javier; Bañuelos, Camino; Pérez-Vizcayno, María J.; Hernández, Rosana; Macaya, Carlos (2012). "Spontaneous Coronary Artery Dissection". JACC: Cardiovascular Interventions. 5 (10): 1062–1070. doi:10.1016/j.jcin.2012.06.014. ISSN 1936-8798.
- ↑ Mortensen, K.H.; Thuesen, L.; Kristensen, I.B.; Christiansen, E.H. (2009). "Spontaneous coronary artery dissection: A Western Denmark Heart Registry Study". Catheterization and Cardiovascular Interventions. 74 (5): 710–717. doi:10.1002/ccd.22115. ISSN 1522-1946.
- ↑ Pasalodos Pita J, Vazquez Gonzalez N, Perez Alvarez L, Vazquez Rodriguez JM, Castro Beiras A (1994). "Spontaneous coronary artery dissection". Cathet Cardiovasc Diagn. 32 (1): 27–32. PMID 8039214.
- ↑ Jorgensen MB, Aharonian V, Mansukhani P, Mahrer PR (1994). "Spontaneous coronary dissection: a cluster of cases with this rare finding". Am. Heart J. 127 (5): 1382–7. PMID 8172069.
- ↑ Zampieri P, Aggio S, Roncon L, Rinuncini M, Canova C, Zanazzi G, Fiorencis R, Zonzin P (1996). "Follow up after spontaneous coronary artery dissection: a report of five cases". Heart. 75 (2): 206–9. PMC 484263. PMID 8673763.
- ↑ Hering D, Piper C, Hohmann C, Schultheiss HP, Horstkotte D (1998). "[Prospective study of the incidence, pathogenesis and therapy of spontaneous, by coronary angiography diagnosed coronary artery dissection]". Z Kardiol (in German). 87 (12): 961–70. PMID 10025069.
- ↑ Adams, Heath; Paratz, Elizabeth; Somaratne, Jithendra; Layland, Jamie; Burns, Andrew; Palmer, Sonny; MacIsaac, Andrew; Whitbourn, Robert (2017). "Different patients, different outcomes: A case-control study of spontaneous coronary artery dissection versus acute coronary syndrome". Journal of Interventional Cardiology. doi:10.1111/joic.12447. ISSN 0896-4327.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Narasimhan, Seshasayee (2004). "Spontaneous coronary artery dissection (SCAD)". Indian Journal of Thoracic and Cardiovascular Surgery. 20 (4): 189–191. doi:10.1007/s12055-004-0084-x. ISSN 0970-9134.
- ↑ 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.
- ↑ 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.