Spontaneous coronary artery dissection. Prospective study of clinical features and outcomes

Abstract

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS). We conducted a prospective observational study on patients diagnosed with SCAD from 2016 to 2021 in our hospital. A total of 17 patients were included, of which 82.4% were women with a mean age of 51+/-10 years old. Among the most prevalent cardiovascular risk factors were smoking and high blood pressure. Only 29.4% of the patients had a predisposing risk factor and 17.6% a precipitating factor. The most frequent clinical presentation was ST-elevation myocardial infarction (70.5%). In most of the coronary angiographies performed, a single artery was affected, being the left anterior descending artery the most frequently involved.  The majority of patients received conservative treatment. Treatment at discharge consisted of dual antiplatelet therapy (94.1%), beta-blockers and statins (88.2% in both cases) and angiotensin-converting enzyme inhibitors (47.1%). After a minimum follow-up of one year, only one patient developed heart failure. 23.5% of patients suffered a new ACS. Only one patient died from non-cardiovascular causes. SCAD is a serious disease that has a favorable prognosis in most cases.