Younger age (≤51 years) was not associated with significant differences in clinical presentation, angiographic features, or long-term MACE (14.1% overall; p>0.05) compared to older patients with SCAD.
Cohort (n=64)
No
Does age (≤51 vs >51 years) influence clinical presentation, angiographic features, or long-term outcomes in patients with spontaneous coronary artery dissection?
Age does not significantly influence clinical presentation, angiographic features, or long-term outcomes in patients with spontaneous coronary artery dissection.
p-value: p=>0.05
Abstract Background Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes, typically affecting young to middle-aged women. However, the potential influence of age on presentation, angiographic pattern, management and outcomes remains unclear. Purpose To compare clinical, angiographic and outcome characteristics of younger versus older patients with SCAD. Methods We retrospectively analyzed consecutive SCAD patients diagnosed between November 2009 and August 2025. Patients were stratified according to the median age (≤51 vs 51 years) to allow balanced group comparison, given the limited sample size. Demographic, clinical, angiographic and follow-up data were compared using chi-square, Fisher’s exact, or Mann–Whitney U tests, as appropriate. Major adverse cardiovascular events (MACE) included cardiovascular death, myocardial infarction, stroke or hospitalization for heart failure. Results The 64-patients cohort was predominantly female (93.8%), with a median age of 51 years (IQR 44–64). Traditional cardiovascular risk factors were infrequent: hypertension in 51.6%, dyslipidemia in 37.5%, and diabetes in 4.7%. Their prevalence did not differ significantly between age groups (p=0.20, p=0.43, and p=1.00, respectively). Younger and older patients had similar clinical presentation (non–ST-segment elevation myocardial infarction in 60.9% overall; p=0.73) and hemodynamic status (Killip class I in 90.6%; p=0.82). The left anterior descending artery was the most frequently affected (57.8%), with no age-related difference in vessel involvement (p=0.64) or dissection type distribution (type 2 most common; p=1.00). Most patients were managed conservatively (90.6%), while percutaneous or surgical revascularization was performed in 7.8% and 1.6%, respectively, with no significant variation by age (p=0.67). Troponin I peak, left ventricular ejection fraction and hospital stay were comparable between groups (all p0.05). After a median follow-up of 69 months (IQR 33–117), MACE occurred in 14.1% of patients and cardiovascular death in 3.1%, with no significant variation by age (all p0.05). Persistent or recurrent chest pain was reported by 20.3% of patients, and new-onset anxiety or depression developed in 12.5% and 3.1%, respectively, with a nonsignificant trend toward higher frequency of psychiatric comorbidities among younger patients (p=0.09). Conclusion In this single-center cohort, no significant age-related differences were observed in clinical presentation, angiographic features or long-term outcomes among SCAD patients. Management should therefore be guided by disease characteristics rather than age, emphasizing the importance of individualized, multidisciplinary and psychosocial follow-up.
Goncalves et al. (Fri,) conducted a cohort in Spontaneous coronary artery dissection (SCAD) (n=64). Younger age (≤51 years) vs. Older age (>51 years) was evaluated on Major adverse cardiovascular events (MACE) (p=>0.05). Younger age (≤51 years) was not associated with significant differences in clinical presentation, angiographic features, or long-term MACE (14.1% overall; p>0.05) compared to older patients with SCAD.