ArticleJACC. Advances2026
Double Trouble: Clinical and Psychological Characteristics in SCAD With and Without Fibromuscular Dysplasia.
Article in JACC. Advances, 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), a cause of acute coronary syndrome predominantly affecting women, is associated with substantial psychological distress. Fibromuscular dysplasia (FMD), a nonatherosclerotic vascular disorder frequently associated with SCAD, adds clinical complexity and may exacerbate distress. However, differences in patient characteristics between SCAD patients with and without FMD remain poorly studied.
objectivesThe objective of the study was to compare demographic, clinical, and psychological characteristics of SCAD patients with and without FMD.
methodsIn this multicenter study, SCAD patients diagnosed <3 years prior underwent chart review for medical data, including FMD screening. Participants completed sociodemographic questionnaires and validated psychological measures: Patient Health Questionnaire-9 (depressive symptoms), Generalized Anxiety Disorder-7 (generalized anxiety), Cardiac Anxiety Questionnaire (cardiac anxiety), and Post-traumatic Stress Disorder Checklist-5 (post-traumatic stress). Between-group differences were analyzed using t-tests and chi-square tests.
resultsOf 326 participants, 296 (90.8%) completed FMD screening, with 128 (43.2%) meeting the diagnostic criteria. Compared to those without FMD, patients with FMD were older, more often females, and more likely to have a history of migraines. Among 67 patients aware of their FMD diagnosis, psychological distress was higher than in those without known FMD: depression 32.8% vs 20.8%, anxiety 31.3% vs 17.4%, cardiac anxiety 64.2% vs 49.2%, and post-traumatic stress 25.4% vs 11.6% (all P < 0.05).
conclusionsSCAD patients who receive a concomitant FMD diagnosis exhibit distinct characteristics and substantially higher psychological distress, highlighting the need for early, comprehensive screening for both FMD, and psychological distress. Given that FMD diagnosis itself may increase psychological burden, anticipatory psychological support and tailored interventions are warranted for this high-risk subgroup.
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