ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Pregnancy-related spontaneous coronary artery dissection: insights from the SCAD-POL registry and a literature review.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPregnancy-associated spontaneous coronary artery dissection (P-SCAD) remains an incompletely characterized cause of acute coronary syndrome during pregnancy and postpartum period. We aimed to compare clinical presentation, comorbidities and outcomes of P-SCAD with non-pregnancy associated spontaneous coronary artery dissection (NP-SCAD).
methodsWe studied 83 women with prior SCAD and at least one pregnancy (aged 44.8 ± 9.7y at SCAD event, 36% with hypertension), including 11 P-SCAD and 72 NP-SCAD cases in SCAD-POL Registry. P-SCAD was defined as SCAD occurring during pregnancy or within 12 months postpartum.
resultsP-SCAD occurred between 2 and 32 weeks after delivery. Compared with NP-SCAD, women with P-SCAD were younger (33.1 ± 4.9 vs 46.4 ± 9.1y, p < 0.001), had higher parity (3.6 ± 1.2 vs 2.5 ± 1.1 pregnancies, p < 0.01) and more often reported ≥ 1 miscarriage (63.5% vs 27.8%, p < 0.05). Pregnancies in the P-SCAD were more frequently complicated with hypertension (45.5% vs 6.9%, p < 0.005) and pre-eclampsia (27.3% vs 1.4%, p < 0.01). All P-SCAD patients had at least one caesarean section versus 35.8% in the NP-SCAD group (p < 0.001). P-SCAD patients more often required coronary bypass grafting (18.2% vs 1.6%, p < 0.05). Frequency of fibromuscular dysplasia was non-significantly higher in P-SCAD (45.5% vs 29.2%).
conclusionsPregnancies in women with P-SCAD were more often complicated by hypertension, pre-eclampsia and miscarriage than in NP-SCAD. P-SCAD events occurred mainly in the early postpartum period and more often required surgical revascularization. Given the small sample, these findings are exploratory and hypothesis-generating.
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