Pregnancy-associated SCAD was associated with more frequent pregnancy complications like hypertension (45.5% vs 6.9%) and a higher need for coronary bypass grafting (18.2% vs 1.6%, p<0.05).
Observational (n=83)
How do clinical presentation, comorbidities, and outcomes differ between pregnancy-associated SCAD and non-pregnancy associated SCAD?
Pregnancy-associated SCAD presents in younger women with more frequent hypertensive pregnancy complications and a higher need for surgical revascularization compared to non-pregnancy associated SCAD.
Absolute Event Rate: 18.2% vs 1.6%
p-value: p=<0.05
BACKGROUND: Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) remains an incompletely characterized cause of acute coronary syndrome during pregnancy and postpartum period. We aimed to compare clinical presentation, comorbidities and outcomes of P-SCAD with non-pregnancy associated spontaneous coronary artery dissection (NP-SCAD). METHODS: We studied 83 women with prior SCAD and at least one pregnancy (aged 44.8 ± 9.7y at SCAD event, 36% with hypertension), including 11 P-SCAD and 72 NP-SCAD cases in SCAD-POL Registry. P-SCAD was defined as SCAD occurring during pregnancy or within 12 months postpartum. RESULTS: P-SCAD occurred between 2 and 32 weeks after delivery. Compared with NP-SCAD, women with P-SCAD were younger (33.1 ± 4.9 vs 46.4 ± 9.1y, p < 0.001), had higher parity (3.6 ± 1.2 vs 2.5 ± 1.1 pregnancies, p < 0.01) and more often reported ≥ 1 miscarriage (63.5% vs 27.8%, p < 0.05). Pregnancies in the P-SCAD were more frequently complicated with hypertension (45.5% vs 6.9%, p < 0.005) and pre-eclampsia (27.3% vs 1.4%, p < 0.01). All P-SCAD patients had at least one caesarean section versus 35.8% in the NP-SCAD group (p < 0.001). P-SCAD patients more often required coronary bypass grafting (18.2% vs 1.6%, p < 0.05). Frequency of fibromuscular dysplasia was non-significantly higher in P-SCAD (45.5% vs 29.2%). CONCLUSIONS: Pregnancies in women with P-SCAD were more often complicated by hypertension, pre-eclampsia and miscarriage than in NP-SCAD. P-SCAD events occurred mainly in the early postpartum period and more often required surgical revascularization. Given the small sample, these findings are exploratory and hypothesis-generating.
Zalewska et al. (Mon,) conducted a observational in Spontaneous coronary artery dissection (n=83). Pregnancy-associated SCAD (P-SCAD) vs. Non-pregnancy associated SCAD (NP-SCAD) was evaluated on Requirement for coronary bypass grafting (p=<0.05). Pregnancy-associated SCAD was associated with more frequent pregnancy complications like hypertension (45.5% vs 6.9%) and a higher need for coronary bypass grafting (18.2% vs 1.6%, p<0.05).