Cardiac Shock Care Centers: JACC Review Topic of the Week
Review Article | By Rab T, Ratanapo S, Kern KB et al.
Despite advances over the past decade, the incidence of cardiogenic shock secondary to acute myocardial infarction has increased, with an unchanged mortality near 50%. Recent trials have not clarified the best strategies in treatment. While dedicated cardiac shock centers are being established, there are no standardized agreements on the utilization of mechanical circulatory support and the timeliness of percutaneous coronary intervention...
Original Research | By Solaru KW, Heupler F, Kim ESH et al.
Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction and sudden cardiac death, particularly in young to middle-aged women. Coronary vasospasm is another condition believed to be associated with SCAD; however, this has only been shown in isolated case reports to date. We sought to examine the association of SCAD and coronary vasospasm by reporting the experience of coronary vasospasm tes...
Original Research | By Jackson R, Al-Hussaini A, Adlam D et al.
OBJECTIVES - This study used optical coherence tomography to investigate the mechanism of false lumen (FL) formation in spontaneous coronary artery dissection (SCAD) by studying: 1) differences between fenestrated and nonfenestrated SCAD; 2) vasa vasorum density; and 3) light attenuation characteristics of the FL. BACKGROUND - SCAD is an increasingly recognized cause of acute coronary syndrom...
Natural History of Spontaneous Coronary Artery Dissection With Spontaneous Angiographic Healing
Original Research | By Hassan S, Prakash R, Saw J et al.
OBJECTIVES - Given the uncertainty regarding the degree and prevalence of spontaneous healing following spontaneous coronary artery dissection (SCAD), the aim of this study was to assess the angiographic characteristics of the dissected segments in a large cohort of patients with SCAD who underwent subsequent repeat coronary angiography. BACKGROUND - SCAD is an uncommon yet important cause of my...
Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes
Original Research | By Saw J, Starovoytov A, Humphries K et al.
AIMS - Spontaneous coronary artery dissection (SCAD) was underdiagnosed and poorly understood for decades. It is increasingly recognized as an important cause of myocardial infarction (MI) in women. We aimed to assess the natural history of SCAD, which has not been adequately explored. METHODS AND RESULTS - We performed a multicentre, prospective, observational study of patients with non-atherosc...
Editorial | By Paré G, Bhatt DL.
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Association of the PHACTR1/EDN1 Genetic Locus With Spontaneous Coronary Artery Dissection
Original Research | By Adlam D, Olson TM, Bouatia-Naji N et al.
BACKGROUND - Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndromes (ACS) afflicting predominantly younger to middle-aged women. Observational studies have reported a high prevalence of extracoronary vascular anomalies, especially fibromuscular dysplasia (FMD) and a low prevalence of coincidental cases of atherosclerosis. PHACTR1/EDN1 is a genetic risk locus for sev...
Early Natural History of Spontaneous Coronary Artery Dissection
Original Research | By Waterbury TM, Tweet MS, Hayes SN et al.
BACKGROUND - Risks and mechanisms of extension of conservatively managed spontaneous coronary artery dissection (SCAD) remain incompletely understood. Study objectives were to (1) evaluate mechanisms of early SCAD evolution through serial angiographic analysis, and (2) determine predictors of early SCAD progression. METHODS AND RESULTS - Retrospective registry study of patients with SC...
Combined use of OCT and IVUS in spontaneous coronary artery dissection