Multicentric Pilot Registry of Spontaneous Coronary Artery Dissection in Argentina

pp. 446-451

Abstract

Background: Spontaneous coronary artery dissection (SCAD) is an important cause of acute myocardial infarction in young adults, particularly women between the fourth and sixth decades of life who often lack traditional cardiovascular risk factors. Given the low incidence of SCAD and the scarcity of local data, a multicenter registry was established to describe the clinical features and outcomes of patients with this condition in our setting.

Objectives: To describe the clinical characteristics, management strategies, and mid- and long-term outcomes of patients with SCAD in our country, where the disease had not been previously well characterized.

Methods: This was a prospective, observational, multicenter study conducted in four private medical centers and two university hospitals. Between January 2023 and January 2025, 26 patients with angiographically confirmed SCAD were included. Collected variables comprised demographic data, cardiovascular risk factors, triggering factors, psychosocial and physical stressors, comorbidities, laboratory findings, angiographic features, treatment strategies, disease resolution, recurrence, and clinical evolution up to one year after hospital discharge.

Results: A total of 26 patients were analyzed over the two-year period; 22 (84.6%) were women, with a median age of 47 years (interquartile range 42–56.5). Hypertension was the most common cardiovascular risk factor, present in 34.6% of patients. Fibromuscular dysplasia was investigated in a minority of cases, with no positive findings, and no pregnancy- or postpartum-related cases were observed. Physical or emotional stress was identified as a triggering factor in 61% of patients. All patients presented with acute coronary syndrome, most commonly non-ST-segment elevation acute coronary syndrome. The left anterior descending artery was the most frequently affected vessel, and type 2A dissection was the predominant angiographic pattern.

Conclusion: SCAD predominantly affects young women and usually presents as non-ST-segment elevation myocardial infarction, with stress as a frequent trigger in this first national pilot registry from our country.