Document Detail


Spontaneous coronary artery dissection: a Western Denmark Heart Registry study.
MedLine Citation:
PMID:  19496145     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) that associates with a high acute-phase mortality rate, whereas long-term outcome is less well described. OBJECTIVE: To describe the incidence, predictors, and prognosis of SCAD. DESIGN: Retrospective case-identification study from the Western Denmark Heart Registry and the database of the Forensic Institute at Aarhus University from 1999 through 2007. RESULTS: SCAD was documented in 22 of 32,869 (0.7 per thousand) angiograms in the angiographic registry. The SCAD incidence among cases of ACS was 22 of 11,175 (2.0 per thousand). None was seen in the forensic database. The mean age was 48.7 +/- 8.9 years (range: 37-71 years). Females constituted 17 of 22 (77%) patients and all had undergone one or more pregnancies; two cases occurred in the postpartum period. The left descending artery (LAD) was the predominant site of entry. The age distribution, prevalence of the cardiovascular risk factors, presence of coronary atherosclerosis, and entry of the dissection were comparable among genders. Treatment was percutaneous coronary intervention in 13 of 22 (59%), coronary artery bypass operation in 2 of 22 (9%), and medical treatment in 7 of 22 (32%) patients. The mean follow-up period was 3.6 +/- 2.9 years. One patient suffered from recurrent SCAD; another patient died suddenly. The MACE- (cardiac death, nonfatal myocardial infarction, and new revascularization) free survival was 81% after 24 months. CONCLUSION: SCAD is a rare disease that mainly affects younger women. Compared with earlier reports, the prognosis seems to be improved by early diagnosis and interventional treatment.
Authors:
K H Mortensen; L Thuesen; I B Kristensen; E H Christiansen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  74     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2010-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  710-7     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley-Liss, Inc.
Affiliation:
Medical Department M (Diabetes and Endocrinology) and Research Laboratories, Aarhus University Hospital, Aarhus Hospital NBG, Aarhus, Denmark. kristian.havmand@ki.au.dk
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / epidemiology*,  etiology,  mortality,  therapy
Adult
Age Factors
Aged
Aneurysm, Dissecting / complications,  diagnosis,  epidemiology*,  mortality,  therapy
Angioplasty, Transluminal, Percutaneous Coronary
Cardiovascular Agents / therapeutic use
Coronary Aneurysm / complications,  diagnosis,  epidemiology*,  mortality,  therapy
Coronary Angiography
Coronary Artery Bypass
Denmark / epidemiology
Disease-Free Survival
Female
Humans
Incidence
Kaplan-Meiers Estimate
Male
Middle Aged
Recurrence
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Time Factors
Treatment Outcome
Ultrasonography, Interventional
Chemical
Reg. No./Substance:
0/Cardiovascular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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