The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Clinical characteristics of spontaneous coronary artery dissection in young female patients with acute myocardial infarction in Korea

  • Kim, Yongcheol (Department of Cardiology, Chonnam National University Hospital) ;
  • Han, Xiongyi (Department of Cardiology, Chonnam National University Hospital) ;
  • Ahn, Youngkeun (Department of Cardiology, Chonnam National University Hospital) ;
  • Kim, Min Chul (Department of Cardiology, Chonnam National University Hospital) ;
  • Sim, Doo Sun (Department of Cardiology, Chonnam National University Hospital) ;
  • Hong, Young Joon (Department of Cardiology, Chonnam National University Hospital) ;
  • Kim, Ju Han (Department of Cardiology, Chonnam National University Hospital) ;
  • Jeong, Myung Ho (Department of Cardiology, Chonnam National University Hospital)
  • Received : 2019.04.05
  • Accepted : 2019.06.10
  • Published : 2021.01.01
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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.

Keywords

Acknowledgement

This study was supported by a grant from Chonnam National University Hospital Biomedical Research Institute (BCRI8015) and by a grant from the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI13C1527).

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