C78 SPONTANEOUS CORONARY ARTERY DISSECTION: THE ROLE OF CORONARY CT ANGIOGRAPHY IN THE FOLLOW–UP MANAGEMENT

Abstract Background Spontaneous coronary artery dissection (SCAD) is one of the causes acute syndrome, myocardial infarction (MI) and sudden death. Although gold standard for diagnosis invasive angiography, Coronary Computed Tomography Angiography (CCTA) a new useful tool follow–up (FU). Treatment could involve conservative or an approach with percutaneous intervention (PCI) bypass grafting. AIMS: 1) analyze clinical CCTA features at baseline patients SCAD; 2) evaluate anatomic outcome treatment; 3) in treated those dismissed single (SAPT) double (DAPT) antiplatelet therapy. Methods Clinical data 57 SCAD, followed up enrolled retrospectively between 2010 ad 2022, were collected FU. The endpoints evaluated were: all mortality, hospitalization cardiovascular cause, SCAD PCI ex–novo MI. patency and/or stents length changing from baseline. Results 46 (80,7%) underwent treatment 11 (19,3%) under PCI. Patients more smokers (45,5% vs 15,2%; p=0,042), had peripherical arteriopathy (18,2% 0%; p=0,034), higher troponin peak (40425,8 13436; p=0,011) lower ejection fraction (51,4±11,0 57,1±7,6; p=0,050). Moreover population significant involvement than (72,7% 6,5%; p<0,001), proximal tracts arteries (22,8% 13 %; p=0,001) truncus communis (45,4% p<0,001). At FU, there no statistical differences two groups (p>0,05). Among therapy, was recurrence DAPT SAPT (33,3% 5,9%; p=0,033). Conclusions managed have risk factors, major extension complex involvement; management comparable to evaluated. discharge associated rate