A-19 | Investigating FMD Screening Rates in Young Female SCAD Patients: Analysis of the National Inpatient Sample

Spontaneous coronary artery dissection (SCAD) is a leading cause of acute coronary syndrome (ACS) in young females without known cardiovascular risk factors and has a strong association with fibromuscular dysplasia (FMD). The largest cohorts studied have demonstrated multifocal FMD in >50% of SCAD patients with up to 11% of patients having head and neck aneurysms/pseudoaneurysms. These findings suggest that further screening is necessary to further evaluate the prevalence of concurrent diagnosis of SCAD and FMD and prevent subsequent vascular events. The National Inpatient Sample (NIS) database encompasses approximately 7 million inpatient hospitalizations annually in the United States. Data were extracted from the National Inpatient Sample (NIS) Database for the years 2016-2020. Patients with diagnosis codes for SCAD and FMD were identified using ICD-10 CM codes (2024 ICD-10-CM Diagnosis Code I77.3 for Arterial fibromuscular dysplasia and 2024 ICD-10-CM Diagnosis Code I25.42 for Coronary artery dissection. Female patients aged 18 to 55 were identified with demographic data. Two-sided t-tests are applied to test if the patients have the same diagnosis rate across teaching versus non-teaching hospitals. We analyzed a total of 2026 female patients aged 18-55 with a primary diagnosis of SCAD, and only 50 patients (2.5%) were found to have a concurrent diagnosis of FMD. When female patients aged 18-55 with SCAD were isolated for the urban teaching hospital setting (1,638 patients total), only 48 patients (2.9%) were found to have a concurrent diagnosis of FMD. The results are statistically significant (p-value < 0.01). This indicates that urban teaching hospitals have a higher diagnosis rate of FMD among SCAD patients possibly due to increased availability of screening resources. The discrepancy in the overall diagnosis rates of concurrent FMD and SCAD between studied cohorts versus the national inpatient samples demonstrates the necessity of improved screening protocols for diagnosis of FMD in young female patients. Appropriate FMD screening can identify salient clinical complications requiring longitudinal follow up and treatment.