Canadian Spontaneous Coronary Artery Dissection Cohort Study: 3-Year Outcomes.

Background: Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction (MI) in young to middle-aged women.

Objectives: We aim to define the long-term natural history of SCAD.

Methods: We performed a multicenter, prospective, observational study of patients with nonatherosclerotic SCAD presenting acutely from 22 North American centers.

Differences in Demographics and Outcomes Between Men and Women With Spontaneous Coronary Artery Dissection.

Background: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction (MI) that most frequently affects women. The characteristics of men with SCAD are less well described.

Objectives: The aim of this study was to describe the characteristics of men with SCAD.

One-Year Prospective Follow-up of Women With INOCA and MINOCA at a Canadian Women's Heart Centre.

Background: Many women with cardiac chest pain and ischemia or myocardial infarction have no obstructive coronary artery disease (INOCA or MINOCA). Studies suggest that these patients have a decreased quality of life and are at increased risk of cardiovascular events. Our study reports 1-year quality of life, frequency of angina, and outcomes following entry into a multidisciplinary Women's Heart Centre (WHC).

Burden of Rare Genetic Variants in Spontaneous Coronary Artery Dissection With High-risk Features.

Importance: The emerging genetic basis of spontaneous coronary artery dissection (SCAD) has been defined as both partially complex and monogenic in some patients, involving variants predominantly in genes known to underlie vascular connective tissue diseases (CTDs). The effect of these genetic influences has not been defined in high-risk SCAD phenotypes, and the identification of a high-risk subgroup of individuals may help to guide clinical genetic evaluations of SCAD.

Objective: To identify and quantify the burden of rare genetic variation in individuals with SCAD with high-risk clinical features.

Association of Dual Antiplatelet Therapy With Ticagrelor With Vein Graft Failure After Coronary Artery Bypass Graft Surgery: A Systematic Review and Meta-analysis.

Importance: The role of ticagrelor with or without aspirin after coronary artery bypass graft surgery remains unclear.

Objective: To compare the risks of vein graft failure and bleeding associated with ticagrelor dual antiplatelet therapy (DAPT) or ticagrelor monotherapy vs aspirin among patients undergoing coronary artery bypass graft surgery.

Data Sources: MEDLINE, Embase, and Cochrane Library databases from inception to June 1, 2022, without language restriction.

Differences in Revascularization Strategy and Outcomes by Clinical Presentations in Spontaneous Coronary Artery Dissection.

Background: Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction (MI). However, the role of revascularization for SCAD according to presentation remains unclear.

Methods: We analyzed patients with SCAD who presented acutely and were participating in the Canadian SCAD Cohort Study.

Coronary Angiographic Manifestations and Outcomes in Spontaneous Coronary Artery Dissection Patients With and Without Fibromuscular Dysplasia.

Background: Fibromuscular dysplasia (FMD) is widely recognized as an important predisposing condition for spontaneous coronary artery dissection (SCAD). However, it remains unclear in SCAD patients with coexistent extracoronary FMD whether SCAD can be attributed to coronary FMD.

Methods: We retrospectively analyzed consecutive patients enrolled in our Vancouver SCAD registries between September 2009 and October 2019 who were screened for extracoronary FMD.

Outcomes of Percutaneous Coronary Intervention in Patients with Spontaneous Coronary Artery Dissection.

Objectives: To compare outcomes of percutaneous coronary intervention (PCI) in spontaneous coronary artery dissection (SCAD) patients versus conservative therapy.

Background: SCAD is an important cause of myocardial infarction (MI) in young-to-middle-aged women. Percutaneous coronary intervention (PCI) is often pursued, but outcomes compared to conservative therapy are unclear.

Chromosome 1q21.2 and additional loci influence risk of spontaneous coronary artery dissection and myocardial infarction.

Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic cause of myocardial infarction (MI), typically in young women. We undertook a genome-wide association study of SCAD (N = 270/N = 5,263) and identified and replicated an association of rs12740679 at chromosome 1q21.2 (P = 2.

Coronary Flow Reserve in Patients With Prior Spontaneous Coronary Artery Dissection and Recurrent Angina.

Background A significant proportion of patients with spontaneous coronary artery dissection (SCAD) have ongoing chronic chest pain despite healing of their dissection. We sought to determine whether coronary microvascular dysfunction contributes to post-SCAD chronic chest pain by performing coronary reactivity testing in the cardiac catheterization laboratory. Methods and Results Eighteen patients consented to coronary reactivity testing at least 3 months post-SCAD.

In-hospital and long-term outcomes among patients with spontaneous coronary artery dissection presenting with ventricular tachycardia/fibrillation.

Background: Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction (MI) in young to middle-age women. Ventricular tachycardia/ventricular fibrillation (VT/VF) may complicate acute SCAD presentations, and the long-term outcomes are unknown.

Objective: The purpose of this study was to report the outcomes of SCAD patients presenting with VT/VF.

Natural History of Spontaneous Coronary Artery Dissection With Spontaneous Angiographic Healing.

Objectives: Given the uncertainty regarding the degree and prevalence of spontaneous healing following spontaneous coronary artery dissection (SCAD), the aim of this study was to assess the angiographic characteristics of the dissected segments in a large cohort of patients with SCAD who underwent subsequent repeat coronary angiography.

Background: SCAD is an uncommon yet important cause of myocardial infarction in women. Very little is known about the characteristics of healing of dissected arteries.

Quantified dual energy computed tomography perfusion imaging using myocardial iodine concentration: Validation using CT derived myocardial blood flow and invasive fractional flow reserve in a porcine model.

Background: Myocardial CT perfusion imaging with dual energy (DE-CTP) can produce myocardial iodine perfusion maps. This study evaluated the accuracy of first pass myocardial iodine concentration in DE-CTP compared to CT derived dynamic myocardial blood flow (MBF) to determine regional myocardial ischemia in an animal model of coronary stenosis using invasive Fractional Flow Reserve (FFR).

Methods: Seven anaesthetised pigs (mean weight 51 ± 4 kg) had a graded coronary artery stenosis produced in six vessels (plus one control animal) using a methacrylate plug with FFR recorded in the target artery (ischemia = FFR<0.

Canadian spontaneous coronary artery dissection cohort study: in-hospital and 30-day outcomes.

Aims: Spontaneous coronary artery dissection (SCAD) was underdiagnosed and poorly understood for decades. It is increasingly recognized as an important cause of myocardial infarction (MI) in women. We aimed to assess the natural history of SCAD, which has not been adequately explored.

Case reports of coronary fibromuscular dysplasia and spontaneous coronary artery dissections.

Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome especially in women. The most common underlying predisposing cause of SCAD is fibromuscular dysplasia (FMD), a non-inflammatory arteriopathy that results in weakening of the affected arteries, and can cause dissection or aneurysm. Coronary FMD (CFMD) was described as rare, and was shown to cause SCAD in histopathological case reports.

Development of a Porcine Model of Coronary Stenosis Using Fully Percutaneous Techniques Suitable For Performing Cardiac Computed Tomography, CT-Perfusion Imaging and Fractional Flow Reserve.

Background: The aim of this study was to develop and describe percutaneous coronary angiographic techniques to create a porcine model of acute coronary stenosis with methacrylate plugs that can by assessed using fractional flow reserve (FFR), invasive coronary angiography and coronary computed tomographic (CT) perfusion imaging without introducing artefacts associated with surgical models.

Methods: Following animal care and institutional approval and using percutaneous coronary catheterisation techniques within an animal laboratory we introduced precision drilled methacrylate plugs into one of the three main coronary arteries of 10 experimental female pigs. Coronary pressure wire measurements were performed across the experimental stenosis for the calculation of FFR.

Ranolazine for Symptomatic Management of Microvascular Angina.

Background: Ranolazine is approved in the United States and Europe for chronic stable angina. Microvascular angina (MVA) is defined as angina with no obstructive coronary artery disease.

Study Question: Our objective was to assess the effectiveness of ranolazine at improving angina scores and quality of life in a Canadian cohort with severe refractory angina due to MVA.

Characteristics of extension and de novo recurrent spontaneous coronary artery dissection.

Aims: Spontaneous coronary artery dissection (SCAD) is an under-recognised and important cause of myocardial infarction in young women. Recurrent SCAD is frequent but poorly understood. We aimed to explore the clinical and angiographic characteristics, and outcomes of recurrent SCAD.