Kaddoura Rasha, Ahmed Ashraf, Al-Hijji Mohammed, Cader Fathima Aaysha, Alasnag Mirvat, Adlam David
Pharmacy Department, Hamad Medical Corporation, Heart Hospital, P.O. Box 3050, Doha, Qatar.
Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610, USA.
Eur Heart J Open. 2025 Mar 19;5(2):oeaf022. doi: 10.1093/ehjopen/oeaf022. eCollection 2025 Mar.
Current data on spontaneous coronary artery dissection (SCAD) predominantly originate from Europe or Caucasians with limited information about other ethnicities. This scoping review presents the evidence on SCAD in non-Western countries. The prevalence of SCAD diagnosis was 1.0% [95% confidence interval (95% CI): 0.0-3.0, = 99%] among patients presenting with myocardial infarction, increasing to 5.0% (95% CI: 1.0-16.0, = 99%) among females. The mean age was 51.3 years with females accounting for 54.0% of patients. A conservative revascularization management was reported in 48.0% (95% CI: 32.0-65.0, = 85%) of patients. Antiplatelet therapy was reported as dual (68.0%, 95% CI: 37.0-89.0, = 90%) in only three studies. A death rate (3.0%) was similar during hospitalization and at mean follow-up of 23.42 months. In conclusion, there is a marked variability in the clinical course of patients with SCAD as well heterogeneity among the included studies. This review identified knowledge gaps in our understanding of SCAD in non-Western countries that should be addressed in future prospective studies.
目前关于自发性冠状动脉夹层（SCAD）的数据主要来自欧洲或高加索人，关于其他种族的信息有限。本范围综述展示了非西方国家中SCAD的相关证据。在心肌梗死患者中，SCAD的诊断患病率为1.0%[95%置信区间（95%CI）：0.0 - 3.0，=99%]，在女性中升至5.0%（95%CI：1.0 - 16.0，=99%）。平均年龄为51.3岁，女性占患者的54.0%。48.0%（95%CI：32.0 - 65.0，=85%）的患者报告采用了保守的血运重建管理。仅在三项研究中，抗血小板治疗报告为双重治疗（68.0%，95%CI：37.0 - 89.0，=90%）。住院期间和平均23.42个月的随访中的死亡率（3.0%）相似。总之，SCAD患者的临床病程存在显著差异，纳入研究之间也存在异质性。本综述确定了我们在非西方国家对SCAD的理解方面的知识空白，这些空白应在未来的前瞻性研究中得到解决。
