Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea
- Author:
Yongcheol KIM
1
;
Xiongyi HAN
;
Youngkeun AHN
;
Min Chul KIM
;
Doo Sun SIM
;
Young Joon HONG
;
Ju Han KIM
;
Myung Ho JEONG
Author Information
- Publication Type:ORIGINAL ARTICLE
- From:The Korean Journal of Internal Medicine 2021;36(1):106-113
- CountryRepublic of Korea
- Language:English
-
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.
Conclusions: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.
