ArticleOpen heart2025
Hypothyroidism in spontaneous coronary artery dissection: presentation, clinical and angiographic findings, management and outcomes.
Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Differential association of hypothyroidism with cardiovascular events and cardiovascular mortality: a systematic review and meta-analysis.Endocrine · 2026Pooled it
- Coronary Artery Disease in Women: Sex-Specific Pathophysiology, Risk Factors, Clinical Presentation and Management.Medicina (Kaunas, Lithuania) · 2026Review
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypothyroidism has been suggested as a predisposing and prognostic factor in patients with spontaneous coronary artery dissection (SCAD), but evidence in this regard is very limited.
methodsThis study sought to compare differences in clinical presentation, angiographic findings, management and outcomes between SCAD patients with (H-SCAD) and without (NH-SCAD) a history of hypothyroidism from the prospective nation-wide Spanish SCAD Registry.
resultsOverall, 47 H-SCAD (12%) and 342 NH-SCAD patients were included. H-SCAD patients when compared with NH-SCAD patients were significantly older (57±10 vs 54±12 years, p=0.045), had more frequent dyslipidaemia (49% vs 31%, p=0.013) and a non-significant trend to more associated fibromuscular dysplasia (47% vs 30%, p=0.191). Clinical presentation did not differ between groups, with non-ST-segment elevation myocardial infarction being the more frequent diagnosis at admission (62% vs 53%, p=0.273). H-SCAD patients showed more frequent multivessel involvement (19% vs 9%, p=0.044), angiographic type 2b lesions (36% vs 23%, p=0.037), lesions at segments with side-branches (68% vs 52%, p=0.026) and tighter lesions (88±13% vs 77±21% diameter stenosis, p=0.001), but less involvement of proximal segments (5% vs 15%, p=0.044). Revascularisation was more commonly needed in H-SCAD patients (34% vs 20%, p<0.05). At late clinical follow-up (median 29 months), the H-SCAD group had a higher adverse event rate (27% vs 11%, p=0.033), mainly driven by myocardial infarction (16% vs 6%, p=0.031) and SCAD recurrence (9% vs 1%, p<0.001). On multivariable analysis, the presence of hypothyroidism remained independently associated with adverse clinical events.
conclusionsH-SCAD patients were older and had a more diffuse and aggressive angiographic phenotype, including type 2b lesions, tighter lesions and more frequent multivessel involvement. Revascularisation was more frequently needed in H-SCAD patients. Long-term outcomes were poorer in this group, mainly driven by myocardial infarction and SCAD recurrence.
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