Management and long-term prognosis of spontaneous coronary artery dissection

Corrado Lettieri, Dennis Zavalloni, Roberta Rossini, Nuccia Morici, Federica Ettori, Ornella Leonzi, Azeem Latib, Marco Ferlini, Daniela Trabattoni, Paola Colombo, Mario Galli, Giuseppe Tarantini, Massimo Napodano, Emanuela Piccaluga, Enrico Passamonti, Paolo Sganzerla, Alfonso Ielasi, Micol Coccato, Alessandro Martinoni, Giuseppe MusumeciRoberto Zanini, Battistina Castiglioni

Research output: Contribution to journalArticlepeer-review

174 Scopus citations


The optimal management and short- and long-term prognoses of spontaneous coronary artery dissection (SCAD) remain not well defined. The aim of this observational multicenter study was to assess long-term clinical outcomes in patients with SCAD. In-hospital and long-term outcomes were assessed in 134 patients with documented SCAD, as well as the clinical impact and predictors of a conservative rather than a revascularization strategy of treatment. The mean age was 52 ± 11, years and 81% of patients were female. SCAD presented as an acute coronary syndromes in 93% of patients. A conservative strategy was performed in 58% of patients and revascularization in 42%. On multivariate analysis, distal versus proximal or mid location of dissection (odds ratio 9.27) and basal Thrombolysis In Myocardial Infarction (TIMI) flow grade 2 or 3 versus 0 or 1 (odds ratio 0.20) were independent predictors of conservative versus revascularization strategy. A conservative strategy was associated with better in-hospital outcomes compared with revascularization (rates of major adverse cardiac events 3.8% and 16.1%, respectively, p = 0.028); however, no significant differences were observed in the long-term outcomes. In conclusion, in this large observational study of patients with SCAD, angiographic features significantly influenced the treatment strategy, providing an excellent short- and long-term prognosis.

Original languageEnglish (US)
Pages (from-to)66-73
Number of pages8
JournalAmerican Journal of Cardiology
Issue number1
StatePublished - Jul 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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