Why the study?
Revascularization strategies for patients with SCAD are poorly established, and the role of intracoronary imaging modalities has not been fully elucidated.
SCAD is increasingly recognized as a major cause of ACS in younger women, typically managed conservatively if hemodynamically stable, with low long-term mortality despite recurrence risks.
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Conservative management appropriate for stable SCAD; leaves open need for prospective trials on recurrence prevention.
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome (ACS) that mostly occurs in middle-aged women. In recent years, it has been attracting attention as a major cause of ACS in younger women. Several case series, middle-scale sample size retrospective cohort studies, and a recent large prospective study have all identified many features of this disorder along with gaps in the literature. Almost all patients with SCAD present ACS and account for 1–4% of all ACS cases. In case of hemodynamically stable patients with thrombolysis in myocardial infarction flow grade 2 to 3, conservative treatment is recommended because healing of the dissected vessel is commonly expected. However, revascularization strategies for patients with SCAD are poorly established. Intracoronary imaging modalities such as intravascular ultrasound and optical coherence tomography have a potential for preventing technical failure during angioplasty and improving the success rate of revascularization, but it has not yet fully elucidated. From existing retrospective studies, long-term mortality is low even though the recurrence of SCAD is not rare. This review will summarize the clinical characteristics, management, and prognosis of SCAD.
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Kahata et al. (2021) studied this question.
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