Key result
SCAD was associated with higher rates of clinically relevant anxiety (36% vs 20% and 12%, p<0.001) and higher perceived stress compared with type 1 MI and healthy controls.
Why the study?
Spontaneous coronary artery dissection is a potentially life-threatening cause of MI mainly affecting young to middle-aged women. This study aimed to assess anxiety and depressive symptoms, perceived stress, and health-related quality of life in SCAD patients compared with type 1 MI patients and healthy controls.
Cross-Sectional (n=501)
Yes
Patients with spontaneous coronary artery dissection experience significantly higher long-term perceived stress, clinically relevant anxiety, and poorer mental health-related quality of life compared to both type 1 myocardial infarction patients and healthy controls, highlighting a need for targeted psychological support in SCAD rehabilitation.
Background Spontaneous coronary artery dissection (SCAD) is a potentially life-threatening cause of myocardial infarction (MI) mainly affecting young to middle-aged women. This study aimed to assess anxiety and depressive symptoms, perceived stress, and Health-Related Quality of Life (HRQoL) in SCAD patients, in comparison to type 1 MI patients and healthy controls. Method A cross-sectional study of 188 SCAD patients, recruited from seven Swedish hospitals and the SWEDEHEART registry, 219 age- and sex-matched type 1 MI patients, recruited via SWEDEHEART and 94 age- and sex-matched healthy controls, recruited via the Swedish population registry. Validated questionnaires RAND-36, Perceived Stress Scale (PSS-14), and Hospital Anxiety and Depression Scale (HADS) were used. Results Mean age±SD for SCAD patients, type 1 MI patients and healthy controls were 55.9±9.8, 60.9±9.4 and 55.5±9.1 years, respectively, and 86.2, 72.1 and 93.6% were women. Median years (IQR) since MI was 4.0(4.3) and 4.0(3.0) for SCAD and type 1 MI patients, respectively. Perceived stress was higher in SCAD patients in comparison with both type 1 MI patients and healthy controls, (mean±SD: 21.9±9.3 vs 18.5±8.7, p<0.001; vs 17.7±7.9, p=0.001). A greater proportion of SCAD patients scored ≥8 points on the HADS-A subscale, indicating clinically relevant anxiety, in comparison with both type 1 MI patients and healthy controls (36% vs 20%, p<0.001; vs 12%, p<0.001). SCAD patients scored lower on the mental component summary (MCS) of RAND-36, than both type 1 MI patients and healthy controls (mean±SD 67.2±22.4 vs 73.7±22.0, p=0.004; vs 82.0±16.6, p<0.001). Conclusions SCAD patients report significantly higher levels of perceived stress and anxiety, and poorer mental health aspects of HRQoL, in comparison with both type 1 MI patients and healthy controls. This is important to consider when forming future SCAD rehabilitation programs.
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Stenberg et al. (2026) conducted a cross-sectional in Spontaneous coronary artery dissection (SCAD) (n=501). Spontaneous coronary artery dissection (SCAD) vs. Type 1 myocardial infarction patients and healthy controls was evaluated on Clinically relevant anxiety (HADS-A score >=8), perceived stress (PSS-14), and mental component summary of HRQoL (RAND-36) (p=<0.001). SCAD was associated with higher rates of clinically relevant anxiety (36% vs 20% and 12%, p<0.001) and higher perceived stress compared with type 1 MI and healthy controls.
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