Evidence map›Paper›PMID 39576481›Full record

ReviewThe Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology2024

In-hospital and long-term clinical outcomes of spontaneous coronary artery dissection (SCAD): a meta-analysis of conservative versus revascularization approaches.

Anmol Pitliya, Aakanksha Pitliya, Srivatsa Surya Vasudevan, Kumari Priya Yadav, Muhammad Bilal Shabbir, Shaghaf Zahoor, Aisha Shabbir, Abdulgafar Dare Ibrahim, Bijay Mukesh Jeswani, Ramya Reddy Jonnala and 1 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Impact of a multidisciplinary clinical pathway on the management of spontaneous coronary artery dissection.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026
    Article
  3. Article
  4. Spontaneous Coronary Artery Dissection Clinical Review: Current State of Evidence and Challenges Ahead.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Anmol PitliyaDepartment of Hospitalist Medicine, Camden Clark Medical Center, Parkersburg, WV, USA.
Aakanksha PitliyaDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA. pitliya.aakanksha@gmail.com.ORCID http://orcid.org/0000-0003-3688-7267
Srivatsa Surya VasudevanDepartment of Otorhinolaryngology- Head and Neck Surgery, Louisiana State University Health Center, Shreveport, LA, USA.
Kumari Priya YadavDepartment of Medicine, Goa Medical College and Hospital, Goa, India.
Muhammad Bilal ShabbirDepartment of Medicine, Army Medical College, Rawalpindi, Pakistan.
Shaghaf ZahoorDepartment of Medicine, Army Medical College, Rawalpindi, Pakistan.
Aisha ShabbirDepartment of Medicine, King Edward Medical University, Lahore, Pakistan.
Abdulgafar Dare IbrahimDepartment of Internal Medicine, Piedmont Atlanta Hospital, Atlanta, GA, USA.
Bijay Mukesh JeswaniDepartment of Medicine, GCS Medical College and Hospital, Ahmedabad, India.
Ramya Reddy JonnalaDepartment of Medicine, AIIMS, Bhopal, India.
Ramit SinglaDepartment of Neurology, Medical University of South Carolina, Columbia, SC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe ideal treatment strategy for spontaneous coronary artery dissection (SCAD) remains unclear, with patients potentially treated with either conservative medical care or a revascularization approach.

methodsWe performed a systematic review and meta-analysis adhering to PRISMA 2020 guidelines. Inclusion criteria involved studies with confirmed SCAD diagnosis, reporting initial management strategies, and original research with ≥ 10 participants. Random-effect models were applied for insignificant heterogeneity with significance at p ≤ 0.05. Sensitivity analysis and funnel plots assessed potential publication bias.

resultsOur analysis found no significant differences in major adverse cardiac events (MACE) (OR = 0.61, p = 0.49), unstable angina pectoris (UAP) (OR = 1.04, p = 0.93), non-ST segment elevation myocardial infarction (NSTEMI) (OR = 1.16, p = 0.82), recurrent myocardial infarction (MI) (OR = 0.78, p = 0.56), stroke (OR = 0.35, p = 0.07), heart failure (OR = 0.41, p = 0.24), in-hospital mortality (OR = 0.35, p = 0.09), post-discharge mortality (OR = 1.66, p = 0.27), or ST segment elevation myocardial infarction (STEMI) (OR = 0.45, p = 0.23) between conservative management and revascularization procedures. However, sensitivity analysis reveals significant decreases in odds of inferior wall STEMI (OR = 0.41 [95% CI 0.17-0.97], p = 0.04) and heart failure (OR = 0.18 [95% CI 0.06-0.54], p = 0.002) in conservative treatment compared to revascularization group.

conclusionConservative therapy significantly decreased inferior wall STEMI and heart failure as compared to revascularization in SCAD. Although no significant differences in cardiovascular outcomes, sensitivity analysis highlights potential benefits of conservative management.

Indexed as

Coronary artery dissectionCoronary diseaseDissected coronary arteryIschemic heart diseaseSpontaneous coronary artery dissection

Identifiers

PMID39576481
PMCPMC11584847

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.