ArticleBMC cardiovascular disorders2025
Unplanned revascularization and major adverse cardiac events in spontaneous coronary artery disease patients: insights from a cardiac center.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The merits of the prognostic nutritional index and neutrophil-to-lymphocyte ratio in predicting outcomes of coronary artery bypass grafting: a retrospective cohort study.BMC cardiovascular disorders · 2026Article
- Pericoronary Adipose Tissue Attenuation in Patients with Spontaneous Coronary Artery Dissection According to Emotional Versus Physical Triggers: An Analysis from the INSIGHT-SCAD Study.Journal of cardiovascular development and disease · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimSpontaneous Coronary Artery Disease (SCAD) is a rare condition that mimics acute coronary syndrome and can lead to serious complications. This study evaluates SCAD characteristics, Major Adverse Cardiac Event (MACE) predictors, revascularization needs, and treatment outcomes. MATERIALS AND
methodsThe single cardiac center, retrospective cohort study analyzed patients diagnosed with coronary artery dissection during coronary angiography between January 2014 and December 2019.
resultsOf 86 patients, 24(27.9%) experienced early MACE. Diffuse dissections (62.5% vs. 37.5%, p = 0.027) and ostium-involving dissections (33.3% vs. 8.1%, p = 0.006) were more frequent in the MACE group. Female patients (58.3% vs. 21.0%, p = 0.001) and those with lower pre-procedural ejection fraction (EF) (44.1 ± 13.5 vs. 55.0 ± 8.8, p = 0.004) or higher neutrophil to lymphocyte ratio (NLR) (5.59 ± 3.67 vs. 3.60 ± 2.46, p = 0.005) had a higher risk. Ostium-involving dissections (OR(Odds Ratio) = 9.41, p = 0.024) and low EF (OR = 0.931, p = 0.040) were independent predictors of MACE. Initial medical treatment is associated with higher unplanned revascularization compared to percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) (p = 0.030). Coronary tortuosity (p = 0.006) and spot lesions (p = 0.005) were associated with late revascularization.
conclusionHigh early MACE after SCAD is associated with female gender, high NLR, and low EF. Diffuse and ostium-involving dissections significantly increase the risk of MACE. Initial treatment has been shown to influence early revascularization. while coronary features like tortuosity predict long-term outcomes. CLINICAL TRIAL NUMBER: Not applicable.
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