Korean J Intern Med.  2021 Jan;36(1):106-113. 10.3904/kjim.2019.118.

Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea

• Kim Y
• Han X
• Ahn Y
• Kim MC
• Sim DS
• Hong YJ
• Kim JH
• Jeong MH

• KMID: 2509760
• DOI: http://doi.org/10.3904/kjim.2019.118

Abstract

Background/Aims
We aimed to evaluate the prevalence, characteristics, and clinical outcomes of spontaneous coronary artery dissection (SCAD) in young female patients with acute myocardial infarction (AMI).
Methods
We identified 8,250 patients diagnosed with AMI who underwent coronary angiogram from the Chonnam National University Hospital database, Gwangju, Korea, between November 2005 and September 2017. A total of 148 female patients aged less than 60 years with a history of AMI were retrospectively studied and the characteristics and clinical outcomes were evaluated for all SCAD patients.
Results
Among female patients with AMI aged less than 60 years, the prevalence of SCAD was 8.78% (13 of 148). Based on the angiographic classification, type 2 SCAD was most commonly observed on angiograms in 69.2% of the cases (nine of 13), followed by type 3 in 23.1% (three of 13), and type 1 in 7.7% (one of 13). Furthermore, the left anterior descending (LAD) artery was the most commonly affected coronary artery (76.9%, 10 of 13 cases) and the distal segments of the coronary arteries were the most common sites of SCAD (92.3%, 12 of 13). Regarding the clinical outcomes, one of 13 patients experienced repeat revascularization during the following 31 months.
Conclusions
The prevalence of SCAD was 8.7%, indicating that SCAD is not rare, among female patients aged less than 60 years with AMI in Korea. Type 2 SCAD was most commonly observed on angiogram. Moreover, the distal portion of the LAD was the segment most commonly affected by SCAD. The long-term clinical outcomes were favorable in patients surviving SCAD.

Keyword

Dissection; Coronary artery disease; Myocardial infarction; Prevalence; Prognosis