Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
Korean J Intern Med. 2021 Jan;36(1):106-113. doi: 10.3904/kjim.2019.118. Epub 2019 Jul 18.
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).
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.
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.
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.
背景/目的：我们旨在评估年轻女性急性心肌梗死（AMI）患者中自发性冠状动脉夹层（SCAD）的患病率、特征和临床结局。
我们从韩国光州的全南国立大学医院数据库中确定了 8250 名接受冠状动脉造影的 AMI 诊断患者，这些患者的诊断时间在 2005 年 11 月至 2017 年 9 月之间。回顾性研究了年龄小于 60 岁且有 AMI 病史的 148 名女性患者，并评估了所有 SCAD 患者的特征和临床结局。
在年龄小于 60 岁的 AMI 女性患者中，SCAD 的患病率为 8.78%（13/148）。根据血管造影分类，2 型 SCAD 在 69.2%（13/13）的病例中最常见，其次是 3 型占 23.1%（3/13），1 型占 7.7%（1/13）。此外，左前降支（LAD）最常受累（76.9%，10/13 例），冠状动脉远端是 SCAD 的最常见部位（92.3%，12/13 例）。在临床结局方面，13 例患者中有 1 例在接下来的 31 个月内再次进行血运重建。
在韩国年龄小于 60 岁的 AMI 女性患者中，SCAD 的患病率为 8.7%，表明 SCAD 并不罕见。血管造影最常见的是 2 型 SCAD。此外，LAD 的远端是最常受累的部位。存活的 SCAD 患者的长期临床结局良好。
