Coronary disease & ACSCohort study
Characteristics and outcomes of spontaneous coronary artery dissection of the left anterior descending artery
- prospective, multicentre registry
- nationwide
- consecutive patients
- angiographically confirmed spontaneous coronary artery dissection (SCAD)
- 34 hospitals across Spain
- central core laboratory
- independently adjudicated clinical events
Authors' conclusion
LAD-SCAD identifies patients with more complex angiographic features and higher long-term risk compared with non-LAD-SCAD. Despite frequent percutaneous coronary intervention, outcomes were not improved in this high-risk LAD population, emphasising the prognostic relevance of dissection location and supporting individualised treatment.
Study context
- Population
- Patients with angiographically confirmed spontaneous coronary artery dissection (SCAD) in the Spanish Registry on SCAD (SR-SCAD)after excluding 8 patients with concomitant left main extension, mean age 54±11.5 years
- Participants
- 388 patients
- Exposure
- Outcomes were compared between patients with and without LAD involvement.
- LAD-SCADn = 190
- Outcome
- Long-term major adverse cardiovascular and cerebrovascular events (MACCE)
- Follow-up
- Long-term
Main finding
As reported in the abstract
Adjusted hazard ratio
2.00
95% CI 1.10–3.97
P = 0.046
Observational data: associations, not effects.
Further findings
Dissection length · longer with LAD
P = 0.01
Multivessel dissection
P < 0.001
Multisegment dissection
P = 0.024
Treated with percutaneous coronary intervention
P = 0.027
Creatine kinase-myocardial band · higher with LAD
P = 0.032
Left ventricular ejection fraction · lower with LAD
P = 0.034
Original publication
Summarised from the published abstract; every number is checked against it