Management and Long-Term Prognosis of Spontaneous Coronary Artery Dissection

被引：230

作者：

Lettieri, Corrado ^{[1
]}

Zavalloni, Dennis ^{[2
]}

Rossini, Roberta ^{[3
]}

Morici, Nuccia ^{[4
]}

Ettori, Federica ^{[5
]}

Leonzi, Ornella ^{[6
]}

Latib, Azeem ^{[7
]}

Ferlini, Marco ^{[8
]}

Trabattoni, Daniela ^{[9
]}

Colombo, Paola ^{[4
]}

Galli, Mario ^{[10
]}

Tarantini, Giuseppe ^{[11
]}

Napodano, Massimo ^{[11
]}

Piccaluga, Emanuela ^{[12
]}

Passamonti, Enrico ^{[13
]}

Sganzerla, Paolo ^{[14
]}

Ielasi, Alfonso ^{[15
]}

Coccato, Micol ^{[11
]}

Martinoni, Alessandro ^{[16
]}

Musumeci, Giuseppe ^{[3
]}

Zanini, Roberto ^{[1
]}

Castiglioni, Battistina ^{[17
]}

机构：

[1] Osped Carlo Poma, Dept Cardiol, Mantua, Italy

[2] Ist Clin Humanitas, Dept Cardiol, Rozzano, Italy

[3] Osped Papa Giovanni XXIII, Dept Cardiol, Bergamo, Italy

[4] Osped Niguarda Ca Granda, Dept Cardiol, Milan, Italy

[5] Spedali Civil Brescia, Dept Cardiol, I-25125 Brescia, Italy

[6] Osped Poliambulanza, Dept Cardiol, Brescia, Italy

[7] Ist Sci San Raffaele, Dept Cardiol, Milan, Italy

[8] Policlin San Matteo, Dept Cardiol, I-27100 Pavia, Italy

[9] Ctr Cardiol Monzino, Dept Cardiol, Milan, Italy

[10] Osped S Anna Como, Dept Cardiol, Como, Italy

[11] Univ Padua, Dept Cardiol, Padua, Italy

[12] Osped L Sacco, Dept Cardiol, Milan, Italy

[13] Ist Ospitalieri, Dept Cardiol, Cremona, Italy

[14] Osped Treviglio Caravaggio, Dept Cardiol, Treviglio, Italy

[15] Osped Mater Domini, Dept Cardiol, Castellanza, Italy

[16] Osped Fornaroli, Dept Cardiol, Magenta, Italy

[17] Osped Circolo Varese, Dept Cardiol, Varese, Italy

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2015年 / 116卷 / 01期

关键词：

CASE SERIES; REVASCULARIZATION; INTERVENTION; DEFINITION;

D O I：

10.1016/j.amjcard.2015.03.039

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The optimal management and short- and long-term prognoses of spontaneous coronary artery dissection (SCAD) remain not well defined. The aim of this observational multicenter study was to assess long-term clinical outcomes in patients with SCAD. In-hospital and long-term outcomes were assessed in 134 patients with documented SCAD, as well as the clinical impact and predictors of a conservative rather than a revascularization strategy of treatment. The mean age was 52 11, years and 81% of patients were female. SCAD presented as an acute coronary syndromes in 93% of patients. A conservative strategy was performed in 58% of patients and revascularization in 42%. On multivariate analysis, distal versus proximal or mid location of dissection (odds ratio 9.27) and basal Thrombolysis In Myocardial Infarction (TIMI) flow grade 2 or 3 versus 0 or 1 (odds ratio 0.20) were independent predictors of conservative versus revascularization strategy. A conservative strategy was associated with better in-hospital outcomes compared with revascularization (rates of major adverse cardiac events 3.8% and 16.1%, respectively, p = 0.028); however, no significant differences were observed in the long-term outcomes. In conclusion, in this large observational study of patients with SCAD, angiographic features significantly influenced the treatment strategy, providing an excellent short- and long-term prognosis. (C) 2015 Elsevier Inc. All rights reserved.

引用

页码：66 / 73

页数：8

共 26 条

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[2]

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