Genetic Features of Spontaneous Coronary Artery Dissection: Potential Diagnostic and Therapeutic Possibilities

Highlights Spontaneous coronary artery dissection (SСAD) is recognized as an important cause of acute myocardial infarction (AMI), especially in young and middle-aged women. Polygenic assessment is currently limited due to the lack of diversity in most large-scale SСAD studies, which tend to have a significant bias towards patients of European origin or study exclusively individuals of European origin. Further studies involving larger and more diverse populations are needed to better understand the various vascular biological mechanisms underlying SСAD and CHD as two different causes of AMI. Abstract Spontaneous coronary artery dissection (SСAD) is recognized as an important cause of acute myocardial infarction (AMI), especially in young and middle-aged women. Studies have revealed the complex genetic architecture underlying SСAD, with variants with different effect sizes playing a role. The purpose of the study is to analyze the current literature on the genetic and clinical factors of SСAD, highlighting those unique factors that distinguish SСAD from atherosclerotic lesions leading to AMI. The primary sources were searched in the electronic databases PubMed, eLibrary and Google Scholar. When identifying both rare and common genetic variations in patients with this pathology, a wide variety of potential genetic mechanisms associated with endothelial cells, extracellular matrix and blood coagulation cascade were revealed. A genetic study of DMCA has revealed important positive links between this disease and other systemic arteriopathies, as well as striking negative links with coronary heart disease and MI. The results have led to the emergence of a new clinical and genetic spectrum of AMI, which may be important for the treatment of AMI, especially in young female patients.