Trends in the Detection, Management and 30-Day Outcomes of Spontaneous Coronary Artery Dissection: A Six-Year, New Zealand Centre Experience

BackgroundSpontaneous coronary artery dissection (SCAD) is an important but under-recognised cause of acute syndrome (ACS), particularly in younger women. We assessed trends the detection, management and outcomes all patients with SCAD over 6 consecutive years.MethodsAll first diagnosis at Christchurch Public Hospital, New Zealand, between January 2014 2020 were included. Patient determined by retrospective review medical records. presentations compared to total ACS presentations, obtained from a national (ANZACS-QI) database.ResultsWe identified 113 angiographic SCAD. Median age was 54 years (88% female). The detection increased period, both as number (Kendall’s ? 0.87, p=0.015) proportion (p value for trend <0.0001). In 2019, represented 2.4% 18% females aged less than 60 years. most common presentation non-ST elevation myocardial infarction (NSTEMI) 72%; and, there increase NSTEMI STEMI period (p=0.023). Initial strategy percutaneous intervention (PCI) undertaken 12% patients, significant towards more conservative approach study (p=0.019). rate 30-day major adverse cardiovascular events (MACE) 8.8% overall, significantly reduced 3% 2019 trend, 0.006).ConclusionsThe has This been largely driven increasing diagnosed SCAD, associated improvement MACE. Spontaneous All database. 0.006).