Distinct demographic profiles of spontaneous coronary artery dissection and coronary artery aneurysm: a single-centre experience from the United Arab Emirates.

Background: Spontaneous coronary artery dissection (SCAD) and coronary artery aneurysm (CAA) are uncommon causes of acute coronary syndromes. Data from the Gulf Cooperation Council countries are limited. This study describes the clinical characteristics, management, and short-term outcomes of patients diagnosed with SCAD or CAA at a tertiary hospital in the United Arab Emirates. Methods: This retrospective observational study was conducted at Tawam Hospital, Al Ain, UAE (October 2018-May 2023). Cases were identified through dual ascertainment: systematic screening of electronic medical records using ICD-10 codes I25.41 (coronary artery aneurysm) and I25.42 (coronary artery dissection), supplemented by cross-referencing with the cardiac catheterization laboratory angiography registry. All identified records underwent independent chart adjudication by two investigators to confirm the diagnoses. Descriptive statistics were used throughout the study; no inferential comparisons were performed given the small sample size. Results: Of 109 records screened, 87 were excluded after chart adjudication (diagnostic misclassification), and 22 underwent a detailed review, yielding nine patients with confirmed diagnoses: six with CAA and three with SCAD. Patients with CAA were exclusively male, with a median age of 59 years (IQR 47.5-75.8), whereas all patients with SCAD were female, with a median age of 41 years (IQR 37.0-63.0). Two of the three patients met the criteria for pregnancy-associated SCAD (onset during pregnancy or within 12 weeks postpartum). One pregnancy-associated SCAD patient presented with cardiac arrest and required emergency coronary artery bypass grafting after a failed percutaneous intervention. The left anterior descending artery was involved in all assessable SCAD cases in this study. Conservative management was adopted in five of six (83.3%) patients with CAA and one of three patients with SCAD. One non-cardiovascular in-hospital death occurred in a patient with CAA admitted for palliative oncology care. All patients with documented follow-up reported improvement in symptoms. Conclusions: CAA and SCAD demonstrated distinct demographic and clinical profiles in this UAE cohort. The predominance of pregnancy-associated SCAD supports the need for heightened cardiovascular vigilance during the postpartum period. The absence of systematic screening for extracoronary arteriopathy represents a missed opportunity for diagnosis. These findings add to the limited Gulf regional data and support the development of prospective registries for uncommon coronary vascular disorders, including SCAD and CAA, in this population.