Spontaneous coronary artery dissection in regions of non-Western populations: a systematic literature search and scoping review

Current data on spontaneous coronary artery dissection (SCAD) predominantly originate from Europe or Caucasians with limited information about other ethnicities. This scoping review presents the evidence on SCAD in non-Western countries. The prevalence of SCAD diagnosis was 1.0% [95% confidence interval (95% CI): 0.0–3.0, I2 = 99%] among patients presenting with myocardial infarction, increasing to 5.0% (95% CI: 1.0–16.0, I2 = 99%) among females. The mean age was 51.3 years with females accounting for 54.0% of patients. A conservative revascularization management was reported in 48.0% (95% CI: 32.0–65.0, I2 = 85%) of patients. Antiplatelet therapy was reported as dual (68.0%, 95% CI: 37.0–89.0, I2 = 90%) in only three studies. A death rate (3.0%) was similar during hospitalization and at mean follow-up of 23.42 months. In conclusion, there is a marked variability in the clinical course of patients with SCAD as well heterogeneity among the included studies. This review identified knowledge gaps in our understanding of SCAD in non-Western countries that should be addressed in future prospective studies.