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Spontaneous Coronary Artery Dissection: Real-World Data from 16 Years of Experience
Session:
Sessão de Posters 43 - Da disseção da artéria coronária às decisões antitrombóticas e de reperfusão nas síndromes coronárias agudas
Speaker:
Joana Gonçalves
Congress:
CPC 2026
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Joana Conde Gonçalves; Luana Alves; Benedita Viana; Tiago Branco; Erivaldo Figueiredo; Emanuel Oliveira; Bernardo Cruz; Mariana Paiva; Rui Rodrigues
Abstract
<p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-family:"Calibri",sans-serif">Background:</span></strong><br /> <span style="font-family:"Calibri",sans-serif">Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes, predominantly affecting young and middle-aged women without traditional atherosclerotic risk factors. Despite growing awareness, uncertainties persist regarding the influence of age and medical therapy on long-term outcomes.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-family:"Calibri",sans-serif">Methods:</span></strong><br /> <span style="font-family:"Calibri",sans-serif">We retrospectively analyzed 64 patients with angiographically confirmed SCAD admitted between November 2009 and August 2025 at a tertiary cardiology center. Demographic, clinical, angiographic, therapeutic, and follow-up data were collected. The primary endpoint was major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, stroke, or hospitalization for heart failure.</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-family:"Calibri",sans-serif">Results:</span></strong><br /> <span style="font-family:"Calibri",sans-serif">The cohort was predominantly female (93.8%) with a median age of 51 years. Hypertension, dyslipidemia and diabetes were present in 51.6%, 37.5%, and 4.7%, respectively. The left anterior descending artery was most frequently involved (57.8%), with type 2 dissection predominating (62.5%). Most patients were managed conservatively (90.6%). At discharge, 79.7% received beta-blockers and 68.8% statins.<br /> Age was not associated with differences in clinical presentation (non–ST-segment elevation myocardial infarction in 60.9%; p=0.73), angiographic pattern (vessel involvement p=0.64; dissection type p=1.00), or treatment strategy (p=0.67).<br /> During a median follow-up of 69 months, MACE occurred in 14.1% of patients and cardiovascular death in 3.1%, with no significant variation by age (all p>0.05). Regarding medical therapy, neither beta-blocker nor statin use was significantly associated with lower rates of MACE or recurrent ischemic events (all p>0.05), although a trend toward greater left ventricular recovery was observed among beta-blocker–treated patients (86.7% vs. 66.7%; p=0.78).</span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong><span style="font-family:"Calibri",sans-serif">Conclusion:</span></strong><br /> <span style="font-family:"Calibri",sans-serif">In this single-center cohort, SCAD predominantly affected middle-aged women and was successfully managed conservatively in most cases. Age did not influence clinical presentation or outcomes. Beta-blockers and statins were frequently prescribed but showed no clear association with improved prognosis, reflecting the limited evidence supporting routine use in SCAD. These findings highlight the need for individualized management and prospective studies to define optimal medical therapy and long-term follow-up strategies in this non-atherosclerotic condition.</span></span></span></p>
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