Table 2.
Summary of Published Research in SCAD
| First Author, Year | Study Design | Outcome | Findings |
|---|---|---|---|
| Saw et al, 20177 | Prospective single-center (Vancouver General Hospital) longitudinal cohort study | 327 patients Assess clinical predictors of recurrent SCAD |
Multivariate analysis demonstrated reduction in recurrent SCAD with use of beta blockers (HR: 0.36, P = 0.004) |
| Edwards et al, 201961 | Cross-sectional pilot study | 14 female patients Assessed psychosocial symptoms |
93% of patients reported symptoms of stress, 57% insomnia, 71% anxiety, 36% depression, and 43% PTSD; majority linked these symptoms to SCAD |
| Johnson et al, 202045 | Cross-sectional study of patients in the Mayo Clinic “Virtual” Multicenter SCAD Registry | 512 patients Assessed psychosocial symptoms |
28% of patients reported at least mild symptoms of PTSD, 41% at least mild symptoms of anxiety, and 32% at least mild symptoms of depression after SCAD |
| Liang et al, 201462 | Cross-sectional study | 158 patients Assessed psychosocial symptoms and related treatment |
33%-37% of patients reported receiving medication or counseling for depression or anxiety post-SCAD Patients with (vs without) peripartum SCAD had higher average depression and anxiety scores |
| Murphy et al, 202463 | Cross-sectional study of patients in the Victor Change Cardiac Research Institute genetics study | 310 patients Assessed psychosocial symptoms and lifestyle impacts of SCAD |
21% of patients reported current anxiety and depression 60% of patients indicated at least 1 SCAD-related impact on work, and 45% reported stopping doing a favorite sport or exercise |
| Sumner et al, 202444 | Cross-sectional study of patients in the iSCAD Registry | 859 patients Assessed SCAD-induced PTSD symptoms, related treatment seeking, and associations with functioning |
Nearly 35% of patients reported symptoms consistent with lifetime probable PTSD; 6.4% met criteria for past-month probable PTSD 34.8% of patients reporting any symptoms of SCAD-induced PTSD sought treatment, yet nearly half of patients with probable PTSD never received treatment for this distress Greater past-month PTSD symptoms were associated with worse past-week sleep disturbance and disease-specific health status |
| Saw et al, 201429 | Review paper | Description of SCAD angiographic classification | |
| Tweet et al, 201430 | Retrospective single-center cohort of patients with first SCAD | 189 patients Assess outcomes of management strategies (conservative, PCI) |
PCI for SCAD has high risk of failure; initial conservative therapy may be preferable CABG for SCAD carries higher early risk and poor graft patency Revascularization for SCAD does not protect against target vessel revascularization or repeat SCAD. |
| Waterbury et al, 20184 | Retrospective registry study of patients with SCAD managed with an initial conservative strategy | 240 patients Evaluation of predictors of SCAD progression |
Isolated IMH may predict progression of SCAD after initial conservative therapy |
| Wells et al, 202458 | Cross-sectional study of patients in the iSCAD Registry | 773 patients Evaluation of migraine-related disability using MIDAS (Migraine Disability Assessment) |
46% current or previous migraines, more common in women and FMD 14.4% mild, 12.7% moderate, and 12.7% severe disability |
CABG = coronary artery bypass grafting; FMD = fibromuscular dysplasia; IMH = intramural hematoma; iSCAD = International Spontaneous Coronary Artery Dissection; PCI = percutaneous coronary intervention; PTSD = post-traumatic stress disorder; SCAD = spontaneous coronary artery dissection.