Key result
Non-traditional risk factors show no link to higher MACE risk versus traditional factors in SCAD.
Why the study?
Spontaneous coronary artery dissection and non-traditional risk factors have assumed increasing interest, but risk estimation models tailored to these factors are lacking.
Does the presence of non-traditional risk factors affect the incidence of major adverse cardiovascular events in patients with spontaneous coronary artery dissection?
Observational (n=62)
No
Does the presence of non-traditional risk factors affect the incidence of major adverse cardiovascular events in patients with spontaneous coronary artery dissection?
Absolute Event Rate: 19.6% vs 9.1%
p-value: p=0.408
Non-traditional risk factors are highly prevalent in patients with spontaneous coronary artery dissection, particularly younger women, but their presence does not significantly alter the incidence of major adverse cardiovascular events compared to traditional risk factors.
Non-traditional risk factors were not linked to higher MACE in SCAD; leaves open whether they should inform prognosis or management.
Background: Spontaneous coronary dissection (SCAD) and non-traditional risk factors (NT-RF) have assumed increasing interest. Aim: To assess NT-RF in the Parma SCAD registry population. Methods: 62 patients with SCAD, enrolled between January 2013 through November 2021, were divided in two groups: NT-RF (n=51) and T-RF (n = 11). Clinical, echocardiographic and angiographic features were compared between the two study populations; finally, the occurrence of major adverse cardiovascular events was assessed at follow-up. Results: At least one NT-RF among sex related, sex prevalent and gender specific risk factors was present in 82% of patients, while TRF for atherosclerotic disease were less common with hypertension being the most prevalent (40.3%) and diabetes the most seldom (3.2%). Patients with NT-RF were significantly younger (p=0.027) and mostly female compared to those without NT-RF (p=0.004). Type 2 (second Yip/Saw classification) dissection was the prevailing phenotype (54.8%) with a higher prevalence in the NT-RF group (63%, p=0.035). Major Adverse Cardiovascular Events (MACEs) occurred in 17.7% in all patients at a median follow-up of 23 months. When comparing the incidence of cardiovascular events in the 2 study groups, we did not find any significant differences (p=0.4) between groups. Conclusion: SCAD occurs more often in younger women without the traditional RF. Risk estimation does not include these factors and tailored prediction models are lacking. Clinicians and researchers should establish targeted interventions for primary prevention, early diagnosis and secondary prevention in younger women.
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Emilia Solinas (2022) conducted an observational in Spontaneous Coronary Artery Dissection (SCAD) (n=62). Non-traditional risk factors (NT-RF) vs. Traditional risk factors (T-RF) was evaluated on Major Adverse Cardiovascular Events (MACEs) (p=0.408). In patients with spontaneous coronary artery dissection, the presence of non-traditional risk factors did not significantly increase the incidence of major adverse cardiovascular events compared to traditional risk factors (19.6% vs 9.1%, p=0.408).
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