SynthesisJACC. Cardiovascular interventions2025
Left Main Spontaneous Coronary Artery Dissection: Clinical Features, Management, and Outcomes.
Synthesis in JACC. Cardiovascular interventions, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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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.
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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.
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Who cites it
5 citing papers in PubMed.
- Left Main Spontaneous Coronary Artery Dissection Complicated by Cardiogenic Shock.JACC. Case reports · 2026Article
- Clinical characteristics, medication, and outcomes of spontaneous coronary artery dissection patients with an initial strategy of percutaneous coronary intervention or conservative therapy.American journal of cardiovascular disease · 2026Article
- Postpartum Spontaneous Coronary Artery Dissection Involving the Left Main Coronary Artery: A Case Report.International journal of women's health · 2026Article
- Case Report: Successful intravascular ultrasound-guided percutaneous coronary intervention of a single coronary artery with chronic total occlusion and severe calcification using rotational atherectomy.Frontiers in cardiovascular medicine · 2026Article
- Shifting Paradigms in SCAD Care: Favoring OMT Over Intervention - Lessons from a National Cohort.Reviews in cardiovascular medicine · 2025Article
Corrections and comments
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Authors and funding
18 authors.
Funding
Abstract
backgroundSpontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial infarction (MI) and is associated with substantial adverse events. SCAD involving the left main coronary artery (LM) is a rare but potentially life-threatening condition. Currently, minimal data on LM SCAD have been reported.
objectivesThe aim of this study was to investigate clinical features, contemporary management, and clinical outcomes of patients with LM SCAD.
methodsA systematic review and pooled analysis of published case reports was conducted using "left main" and "dissection" as keywords. The authors screened 1,106 papers in MEDLINE and Embase published between 1990 and 2023.
resultsThe final analysis included 132 patients (mean age 40 ± 11 years, 80% women) diagnosed with LM SCAD. Remarkably, 36% of cases occurred during pregnancy, and 95% presented with acute coronary syndrome, 22% with cardiogenic shock, and 8% with ventricular arrhythmias. At 120-day median follow-up, all-cause death occurred in 9%, left ventricular assist device implantation or heart transplantation in 4%, recurrent MI in 13%, and urgent myocardial revascularization (MR) in 21%. Compared with conservative management, early revascularization by percutaneous coronary intervention or coronary artery bypass grafting significantly reduced the composite endpoint of all-cause death, left ventricular assist device implantation or heart transplantation, recurrent MI, and urgent MR (adjusted HR: 0.37; 95% CI: 0.20-0.69; P < 0.001).
conclusionsLM SCAD carried significant acute morbidity and mortality. Early revascularization (percutaneous coronary intervention or coronary artery bypass graft) was associated with a lower incidence of early adverse outcomes compared with conservative management, driven largely by reduction in recurrent MI and urgent MR. These hypothesis-generating data should be confirmed in future prospective registries and clinical trials.
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