THE CHARACTERISTICS AND CLINICAL COURSE OF SPONTANEOUS CORONARY ARTERY DISSECTION: DIFFERENCES BETWEEN PATIENTS WITH AND WITHOUT HYPERTENSION- INSIGHTS FROM SCAD-POL REGISTRY
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Le résumé fourni par la source
Objective: Spontaneous coronary artery dissection (SCAD) is one of the causes of acute coronary syndrome of unknown etiology. Potential risk factors and comorbidities are female gender, fibromuscular dysplasia (FMD) and increased tortuosity. HTN is associated with increased coronary tortuosity and both have been shown to increase the risk of recurrence after SCAD. The aim of this study was to assess angiographic data and clinical course of SCAD in patients with HTN. Design and method: the study group comprised of 94 consecutive patients (97.8% females, aged 44.4 ± 9.3 years) with a history of angiographically confirmed SCAD, included in nationwide SCAD-POL registry. All medical records were gathered and angiography images reviewed, classifying SCAD type according to ESC classification. Patients (n=87) underwent head-to pelvis computed tomography angiography for FMD screening. Results: 34 patients (97.1% females) had HTN. Hypertensive patients were characterized by increased age (48.5 ± 10.0 vs 42.1 ± 8.1 years, p<0.005), had more often hyperlipidemia (32.3 vs 11.7%, p<0.05) and more frequently were diagnosed with NSTEMI (70.6 vs 48.43%, p<0.05). FMD was diagnosed more often in patients with HTN (48.5% vs 23.7%, p<0.05). Looking at the distribution of FMD, the prevalence of FMD in cervical arteries was significantly higher in patients with HTN (28.1% vs 8.5%, p<0.05). In patients with HTN, proximal segments of coronary arteries were much less frequently affected by SCAD (11.8 vs 31.7%, p<0.05) and type 2b SCAD was more often observed (26.5 vs 10.0%, p<0.05). There were no differences in terms of PCI (32.3 vs 36.7%) and conservative management (67.6 vs 58.3%) between hypertensive and non-hypertensive subjects. Although, the left ventricle dysfunction (EF<50%) was less frequently observed at discharge in patients with HTN (10.7 vs 41.8%, p<0.01). Conclusions: patients with HTN were characterized by more favorable angiographic characteristics and clinical course of SCAD and higher prevalence of FMD. Further investigation of the relationship between hypertension, coronary tortuosity and the course of SCAD is merited.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- THE CHARACTERISTICS AND CLINICAL COURSE OF SPONTANEOUS CORONARY ARTERY DISSECTION: DIFFERENCES BETWEEN PATIENTS WITH AND WITHOUT HYPERTENSION- INSIGHTS FROM SCAD-POL REGISTRY
- Date Crossref
- 01/05/2024
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Institute of Cardiology Dept. of Invasive Cardiology and Angiology pays non établi dans la noticeStructure de recherche
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Medical University of Warsaw I Cardiac Dept. pays non établi dans la noticeUniversité ou école supérieure
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Western Hospital pays non établi dans la noticeÉtablissement de santé
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Glenfield Hospital pays non établi dans la noticeÉtablissement de santé
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NIHR Leicester Biomedical Research Centre pays non établi dans la noticeStructure de recherche
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Western Specialist Hospital Dept. of Invasive Cardiology pays non établi dans la noticeÉtablissement de santé
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Masovian Specialist Hospital Dept. of Interventional Cardiology pays non établi dans la noticeÉtablissement de santé
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Bielanski Hospital Dept. of Cardiology pays non établi dans la noticeÉtablissement de santé
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Dept. of Cardiovascular Sciences and Leicester NIHR Biomedical Research Centre pays non établi dans la noticeStructure de recherche
Dept. of Invasive Cardiology and Angiology — Institute of Cardiology, I Cardiac Dept. — Medical University of Warsaw et Western Hospital, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.