Prognostic implications of left ventricular systolic dysfunction in patients with spontaneous coronary artery dissection
Authors' conclusion
Patients with SCAD and reduced LVEF show differences in clinical characteristics and angiographic findings compared with SCAD patients with preserved LVEF. Although these patients receive specific medications at discharge, they had higher mortality and readmission rates for HF during follow-up.
Study context
- Population
- Patients with spontaneous coronary artery dissection (SCAD), Spanish multicentre registry; Left ventricular ejection fraction (LVEF) by echocardiography during index admission348 with LVEF assessed
- Participants
- 389 patients
- Exposure
- Reduced LVEF vs preserved LVEF in SCAD
- Reduced LVEFn = 53
- Preserved LVEFn = 295reference
- Outcome
- Combined adverse event
- Follow-up
- Median 28 months
Methodological detailsregistry, multicentre, consecutive patients, Mean age 54 years; 90% women in both groups
- Registry
- Multicentre
- Consecutive patients
- Mean age 54 years; 90% women in both groups
Main finding
As reported in the abstract
P = 0.13
Observational data: associations, not effects.
Further findings
Mortality · median follow-up 28 months
P < 0.001
HF readmission · median follow-up 28 months
P = 0.01
In-hospital events · index admission
P = 0.01
STEMI presentation · especially anterior STEMI
P < 0.001
In-hospital events · index admission
- Higher rates of death, cardiogenic shock, ventricular arrhythmia and stroke with reduced LVEF
Angiography, revascularization, medication
- Proximal and multi-segment involvement significantly more frequent with reduced LVEF
- No differences in initial revascularization
- Reduced LVEF: more neurohormonal antagonist therapy, less aspirin
Original publication
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