Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea
0
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
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.
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.
참고문헌 (23)
- Alfonso F, "Spontaneous coronary artery dissection : novel diagnostic insights from large series of patients", Circ Cardiovasc Interv, 7, pp.638~641 (2014)
- Vanzetto G, "Prevalence, therapeutic management and medium-term prognosis of spontaneous coronary artery dissection : results from a database of 11, 605 patients", Eur J Cardiothorac Surg, 35, pp.250~254 (2009)
- Nakashima T, "Prognostic impact of spontaneous coronary artery dissection in young female patients with acute myocardial infarction : a report from the Angina Pectoris-Myocardial Infarction Multicenter Investigators in Japan", Int J Cardiol, 207, pp.341~348 (2016)
- Rashid HN, "Incidence and characterisation of spontaneous coronary artery dissection as a cause of acute coronary syndrome : a single-centre Australian experience", Int J Cardiol, 202, pp.336~338 (2016)
- Mortensen KH, "Spontaneous coronary artery dissection : a Western Denmark Heart Registry study", Catheter Cardiovasc Interv, 74, pp.710~717 (2009)
- Kim Y, "The role of optical coherence tomography in the setting of acute myocardial infarction", J Cardiol, 72, pp.186~192 (2018)
- Kim Y, "The role of optical coherence tomography in decision making during the acute phase of spontaneous coronary artery dissection", Int J Cardiol Heart Vasc, 14, pp.6~7 (2016)
- Kim Y, "Assessment for ambiguous angiographic finding in patient with acute myocardial infarction by optical coherence tomography", Cardiol J, 25, pp.536~537 (2018)
- Nishiguchi T, "Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome", Eur Heart J Acute Cardiovasc Care, 5, pp.263~270 (2016)
- Saw J, "Nonatherosclerotic coronary artery disease in young women", Can J Cardiol, 30, pp.814~819 (2014)
- Tweet MS, "Clinical features, management, and prognosis of spontaneous coronary artery dissection", Circulation, 126, pp.579~588 (2012)
- Lettieri C, "Management and long-term prognosis of spontaneous coronary artery dissection", Am J Cardiol, 116, pp.66~73 (2015)
- Saw J, "Spontaneous coronary artery dissection : clinical outcomes and risk of recurrence", J Am Coll Cardiol, 70, pp.1148~1158 (2017)
- Kim Y, "Results of a 10-year experience in Korea using drug-eluting stents during percutaneous coronary intervention for acute myocardial infarction(from the Korea Acute Myocardial Infarction Registry)", Am J Cardiol, 122, pp.365~373 (2018)
- 김용철, "Current status of acute myocardial infarction in Korea", The Korean Journal of Internal Medicine, 34(1), pp.1~10 (2019), 대한내과학회[DOI]
- Saw J, "Contemporary review on spontaneous coronary artery dissection", J Am Coll Cardiol, 68, pp.297~312 (2016)
- Austen WG, "A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association", Circulation, 51(4 Suppl), pp.5~40 (1975)
- Saw J, "Spontaneous coronary artery dissection : association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes", Circ Cardiovasc Interv, 7, pp.645~655 (2014)
- Rogowski S, "Spontaneous coronary artery dissection : angiographic follow-up and long-term clinical outcome in a predominantly medically treated population", Catheter Cardiovasc Interv, 89, pp.59~68 (2017)
- Adlam D, "European Society of Cardiology, Acute Cardiovascular Care Association, SCAD study group : a position paper on spontaneous coronary artery dissection", Eur Heart J, 39, pp.3353~3368 (2018)
- Hayes SN, "Spontaneous coronary artery dissection : current state of the science : a scientific statement from the American Heart Association", Circulation, 137, pp.e523~e557 (2018)
- Buccheri D, "Pulse on spontaneous coronary artery dissections : experience-based survey", JACC Cardiovasc Interv, 10, pp.1469~1471 (2017)
- Neumann FJ, "2018 ESC", EACTS guidelines on myocardial revascularization, 2019, pp.40, 87~165