ArticleBMC cardiovascular disorders2026
Factors associated with a complicated hospital course in patients with spontaneous coronary artery dissection: a report of the iSCAD registry.
Article in BMC cardiovascular disorders, 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
backgroundSpontaneous coronary artery dissection (SCAD) is a cause of acute coronary syndrome, particularly in younger individuals. In-hospital complications can result in adverse outcomes, including repeated procedures and prolonged hospital stays. There is a need to identify patients who are at a higher risk of adverse events or a more complex hospital course.
methodsUsing data from the iSCAD Registry, a multicenter registry of patients with SCAD, we built univariate and multivariable logistic regression models to assess the association between baseline factors related to the index admission and a complicated hospital course. A complicated hospital course was defined as the occurrence of recurrent myocardial infarction (MI), cerebrovascular accident (CVA), a new arrhythmia, heart failure requiring diuretics, ≥ 2 angiograms performed, need for mechanical support or a hospital admission of more than 5 days. The multivariable logistic regression model was developed using a backward selection approach with exit criteria set at p > 0.2.
resultsOf the 984 patients included, 219 patients (22.3%) had a complicated hospital course. In our final multivariable model, the following was associated with an increased risk of complicated hospitalization: Obesity, history of cardiomyopathy, arrest or shock at presentation, left anterior descending artery dissection, reduced ejection fraction, presence of structural complications, coronary artery bypass grafting, and current or prior history of P-SCAD.
conclusionIn our cohort of patients with SCAD, we identified baseline characteristics that were associated with a risk of complex hospitalization. Recognizing these risk factors can help tailor acute care and guide decisions on closer observation.
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