| Spontaneous coronary artery dissection: aggressive vs. conservative therapy. | |
| | |
MedLine Citation:
|
PMID: 20440039 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is a rare condition that commonly presents as an acute coronary event in the younger population, especially in females of childbearing age. Generally, there is no consensus on the etiology, prognosis, and treatment of SCAD. METHODS: The Medline database was searched for "spontaneous coronary artery dissection" between 1931 and 2008. A total of 440 cases of SCAD were identified. Demographic data were analyzed with either the Student's t-test or the chi-square test for categorical and nominal variables, respectively. Kaplan-Meier outcome analysis was used to assess the outcome of a given treatment for all patients after 1990. RESULTS: SCAD was found more commonly in females with 308 (70%) cases. Pregnancy was associated with SCAD in 80 (26.1%) cases. Among pregnant patients, 67 (83.8%) developed SCAD in the postpartum period and 13 (16.2%) patients in the prepartum period. Analysis of treatment modalities showed that 21.2% of the patients who were conservatively managed after the initial diagnosis eventually required surgical or catheter-based intervention compared to 2.5% of patients who were initially treated with an aggressive strategy. Kaplan-Meier analysis showed that patients with an isolated single lesion in left or right coronary artery had a statistically significant better outcome when treated with an early aggressive strategy, including coronary artery bypass grafting (CABG) or stent placement as compared to a conservative strategy (p = 0.023, p = 0.006, respectively). CONCLUSION: Early intervention with either CABG or percutaneous coronary intervention following the diagnosis of SCAD leads to a better outcome and less need for further intervention. |
| | |
Authors:
|
Behrooz K Shamloo; Rajesh S Chintala; Ali Nasur; Mohammad Ghazvini; Parastoo Shariat; James A Diggs; Steven N Singh |
Related Documents
:
|
8362709 - Angiographic suitability for catheter revascularization of total coronary occlusions in... 19749169 - Extraction of morphometry and branching angles of porcine coronary arterial tree from c... 23375949 - In vivo distribution of particulate matter from coated angioplasty balloon catheters. 6743189 - Diameter of coronary arteries in 36 species of mammalian from mouse to giraffe. 22910529 - Severe aortic stenosis, bicuspid aortic valve and atrial septal defect in a child with ... 22323939 - Modified 'y-configured stents with waffle cone technique' for broad neck basilar top an... 573369 - Echocardiogram analysis in a pattern recognition framework. 7048839 - Material thrombogenicity in central venous catheterization. i. a comparison between unc... 21611029 - Helical ct angiography of fenestrated stent grafting of abdominal aortic aneurysms. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Meta-Analysis; Review |
Journal Detail:
|
Title: The Journal of invasive cardiology Volume: 22 ISSN: 1557-2501 ISO Abbreviation: J Invasive Cardiol Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-05-04 Completed Date: 2010-08-20 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 222-8 Citation Subset: IM |
Affiliation:
|
Department of Internal Medicine, Division of Cardiovascular Diseases, Howard University Hospital, Washington, DC, USA. bzshamloo@gmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aneurysm, Dissecting* / mortality, surgery, therapy Angioplasty, Transluminal, Percutaneous Coronary / mortality* Coronary Artery Bypass / mortality* Coronary Artery Disease* / mortality, surgery, therapy Female Humans Kaplan-Meiers Estimate Male Middle Aged Pregnancy Pregnancy Complications, Cardiovascular* / mortality, surgery, therapy Stents / statistics & numerical data |
| Comments/Corrections | |
Comment In:
|
J Invasive Cardiol. 2010 May;22(5):229-30
[PMID:
20440040
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Longer-term outcomes of Paclitaxel stent implantation as an initial treatment strategy for sirolimus...
Next Document: Unprotected left main angioplasty in nonagenarians: clinical characteristics, procedural features an...