Small study finds recurrent spontaneous coronary artery dissection risk not associated with subsequent pregnancy

Référence

Tweet MS, Young KA, Best PJM, et al. Association of pregnancy with recurrence of spontaneous coronary artery dissection among women with prior coronary artery dissection. JAMA Network Open 2020;3(9):e2018170

Sommaire

SCAD is a nonatherosclerotic cause of acute coronary syndrome (ACS) that occurs in women of childbearing age. SCAD recurrence is defined as ACS or cardiac arrest due to SCAD in a different coronary artery. Risk factors for SCAD recurrence and effective prevention measures are unknown. These investigators analyzed data obtained from an international registry of patients who met standard diagnostic criteria for SCAD. The initial cohort consisted of 636 women of childbearing age and potential with a history of SCAD. Of these, 23 women (median age 38 years; range 34 to 40 years) had a total of 32 pregnancies and 2 of these women (9%) experienced recurrent SCAD. A total of 92 cases of recurrent SCAD, defined as those with a recurrence at least 1 month after the initial SCAD, were matched to 158 control patients with no history of recurrence on the basis of age, year of first SCAD, and the presence or absence of fibromuscular dysplasia on coronary imaging. No significant difference occurred in the number of subsequent pregnancies in the women with recurrent SCAD (cases) compared with matched control patients (2% vs 8%; P = NS).