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Spontaneous coronary artery dissection: A single-center case series and literature review

dc.contributor.authorAbreu, G
dc.contributor.authorGalvão Braga, C
dc.contributor.authorCosta, J
dc.contributor.authorAzevedo, P
dc.contributor.authorMarques, J
dc.date.accessioned2019-01-18T16:17:19Z
dc.date.available2019-01-18T16:17:19Z
dc.date.issued2018-08
dc.description.abstractBACKGROUND: Spontaneous coronary artery dissection (SCAD) is an unusual cause of acute coronary syndrome (ACS). Better recognition and diagnosis has raised awareness of this condition. However, the pathophysiology of SCAD and its prognosis are still little understood. We aimed to investigate the characteristics and prognosis of patients with SCAD, and subsequently performed a review of literature. METHODS: Single-center, retrospective study performed in patients hospitalized from January 2010 to December 2016 with suspected ACS (n=5002) whose final diagnosis was SCAD (n=27; 0.5%). RESULTS: Patients with SCAD were mainly female (81.5%; n=22), with median age of 56. Predisposing factors were identified in 12 (44%) patients and precipitating factors in three (11.1%). Non-ST elevation myocardial infarction (NSTEMI) was the main form of presentation (51.9%). The left anterior descending artery (LAD) territory was the most commonly involved (n=12, 44.4%). Type 2 dissection was the most prevalent angiographic pattern (n=17, 63%). The majority of patients (n=15; 55.6%) were managed medically and the remaining patients underwent percutaneous coronary intervention (PCI) with drug-eluting stents. Seven patients re-infarcted while in the hospital. Over the median follow-up period of 20 months, 7.4% of patients (n=2) had symptoms of heart failure (HF) and 14.8% developed ACS (in three patients the event occurred in a coronary territory other than that of the index case, and in one patient it occurred in the previously affected territory). There were no deaths. CONCLUSION: In the studied population, SCAD was more prevalent in middle-aged women. Despite the high prevalence of in-hospital re-infarction or during follow-up, the prognosis was good overall.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2018 Aug;37(8):707-713pt_PT
dc.identifier.doi10.1016/j.repc.2017.07.019pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.23/1306
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.subjectSíndrome Coronária Agudapt_PT
dc.subjectAnomalias dos Vasos Coronáriospt_PT
dc.titleSpontaneous coronary artery dissection: A single-center case series and literature reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage713pt_PT
oaire.citation.issue8pt_PT
oaire.citation.startPage707-713pt_PT
oaire.citation.volume37pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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