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纤维肌性发育不良患者的特征和预后在自发性冠状动脉夹层人群中(来自法国自发性冠状动脉夹层登记处“DISCO”)。

Characteristics and Prognosis of Patients With Fibromuscular Dysplasia in a Population of Spontaneous Coronary Artery Dissections (from the French Registry of Spontaneous Coronary Artery Dissections "DISCO").

机构信息

Department of Cardiology, Clermont-Ferrand University Hospital Center, Centre National de la Recherche Scientifique, Clermont Auvergne University, Clermont-Ferrand, France.

Department of Cardiology, Clermont-Ferrand University Hospital Center, Centre National de la Recherche Scientifique, Clermont Auvergne University, Clermont-Ferrand, France.

出版信息

Am J Cardiol. 2022 Jul 15;175:38-43. doi: 10.1016/j.amjcard.2022.04.007. Epub 2022 May 11.

Abstract

Spontaneous coronary artery dissection (SCAD) and fibromuscular dysplasia (FMD) are pathologies that appear to be closely related. This study compares the characteristics of the FMD population to the non-FMD population in a SCAD cohort. It thus assesses the involvement of the FMD phenotype in a SCAD population. From the data of the French DISCO registry, we included patients with a diagnosis of SCAD and in whom a search for FMD was performed. We collected the following characteristics of this population: the clinical and angiographic presentation, the data concerning the management, and the events occurring during the follow-up. In the 373 SCADs confirmed in the DISCO registry, we obtained imaging data for 340 of them. FMD was found in 45% of cases. The mean age was higher in the FMD group, 53.2 ± 8.8 years, versus 50.1 ± 11 years in the non-FMD group. High blood pressure and postmenopausal status were significantly higher in the FMD group. Clinical presentation, angiographic data, and management were comparable. The major adverse cardiac event rate and recurrence rate were not different between the 2 groups after 1 year of follow-up. In conclusion, we confirmed a 45% prevalence of FMD in the SCAD population. The median age was higher in the FMD group, suggesting that FMD may develop over time. The rate of major adverse cardiac events and recurrence were similar in the FMD group versus the non-FMD group after 1 year of follow-up.

摘要

自发性冠状动脉夹层 (SCAD) 和纤维肌性发育不良 (FMD) 似乎密切相关。本研究比较了 SCAD 队列中 FMD 人群与非 FMD 人群的特征。从而评估了 FMD 表型在 SCAD 人群中的参与程度。从法国 DISCO 注册中心的数据中,我们纳入了诊断为 SCAD 且进行 FMD 检查的患者。我们收集了该人群的以下特征:临床和血管造影表现、管理数据以及随访期间发生的事件。在 DISCO 注册中心确认的 373 例 SCAD 中,我们获得了其中 340 例的影像学数据。FMD 见于 45%的病例。FMD 组的平均年龄更高,为 53.2±8.8 岁,而非 FMD 组为 50.1±11 岁。FMD 组高血压和绝经后状态明显更高。临床表现、血管造影数据和管理相似。在 1 年随访后,两组之间主要不良心脏事件率和复发率无差异。总之,我们证实了 SCAD 人群中 FMD 的患病率为 45%。FMD 组的中位年龄较高,提示 FMD 可能随着时间的推移而发展。在 1 年随访后,FMD 组与非 FMD 组之间主要不良心脏事件和复发的发生率相似。

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