Correlation between therapy strategy and long-term prognosis of spontaneous coronary artery dissection
LI Meng
GAN Tian
WU Ri-na
SONG Xiu-rong
WANG Yi-hua
LI Xiao-qiong
Abstract：Objective To analyze retrospectively the clinical characteristics and selection of therapy strategy in patients with spontaneous coronary artery dissection (SCAD).Methods The outcomes of coronary angiography (CAG) were retrospectively analyzed in 4413 patients, and 9 patients were diagnosed with SCAD from Jan. 2005 to Feb. 2015, and SCAD was classified according to the classification criterion of coronary artery dissection. The incidence of SCAD, imagine features and clinical follow-up results of different type SCAD were analyzed.Results Among 9 patients, there were 3 (33.3%) with 2 lesions of SCAD, and there were totally 12 lesions of SCAD. There were 8 (88.9%) with clinical events, and 1 (11.1%) without symptoms. There were 10 (83.3%) type I SCAD, 1 (8.3%) type Ⅱ SCAD and 1 (8.3%) type Ⅱ SCAD. There were 9 lesions of SCAD with conservative treatment in 6 patients, 2 with PCI in 2 patients, and there were 2-vessel SCAD in 1 patient, one vessel treated with PVI and one with conservative treatment. There were 3 lesions of SCAD treated with PCI successfully. Six patients with type I SCAD were given drug treatment for 6 m to 12 m and then given CAG re-examination, and the outcomes showed that SCAD had no significant changes. One patient with type I SCAD was given drug treatment for 3 m, who still had angina pectoris and was given PCI then. Two patients with type Ⅱ SCAD were given conservative treatment for 12 m, and outcomes of CAG re-examination showed that intramural hematoma (IMH) was relieved.Conclusion SCAD can be classified into 3 types. The patients with type I SCAD can select intervention therapy but there is operational risk, and patients with type Ⅱ SCAD (IMH) will have optimistic prognosis after selecting drug conservative treatment. PCI can be applied selectively according to types and lengths of SCAD lesions. A part of SCAD patients have optimistic prognosis after selecting drug conservative treatment, but long-term observation is needed in follow-up period for getting know SCAD healing condition.
Keywords：Spontaneous coronary artery dissectionIntervention therapyConservative treatment
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 218-221 )