Spontaneous Coronary Artery Dissection in the Gulf: G-SCAD Registry
Amin Daoulah 1, Salem M Al-Faifi 2, Sameer Alhamid 3, Ali A Youssef 4 5, Mohammed Alshehri 6, Mushabab Al-Murayeh 7, Tarek Farghali 8, Mohamed Maghrabi 1 9, Mohammed Balghith 10, Osama ElSayed 1, Abdulaziz Alasmari 2, Amr A Arafat 11, Ahmed F Elmahrouk 12, Akram Eldesoky 13, Wael A Refaat 14, Saif S Alshahrani 15, Abdulrahman M Ghazi 4, Karim M Al-Azizi 16, Ziad Dahdouh 17, Amir Lotfi 18
Affiliations
Affiliations
- 1Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia.
- 2Department of Internal Medicine, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia.
- 3Department of Emergency Medicine, 37849King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
- 4Department of Cardiology, 289167Saud Al Babtain Cardiac Center, Dammam, Kingdom of Saudi Arabia.
- 5Department of Cardiology, 68831Suez Canal University, Ismailia, Egypt.
- 6Department of Cardiology, 48077Prince Khaled Bin Sultan Cardiac Center, Khamis Mushait, Kingdom of Saudi Arabia.
- 7Department of Cardiology, 48103Aseer Central Hospital, Abha, Kingdom of Saudi Arabia.
- 8Department of Cardiology, 68796Assiut University, Assiut, Egypt.
- 9Department of Cardiology, Al Hada Military Hospital, Taif, Kingdom of Saudi Arabia.
- 10Department of Cardiology, 48149King Saud Bin Abdulaziz University for Health Science, Riyadh, Kingdom of Saudi Arabia.
- 11Cardiothoracic Surgery Department, Faculty of Medicine, 68781Tanta University, Egypt.
- 12Cardiothoracic Surgery Section, Department of Cardiology, 195017King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia.
- 13Department of Cardiology, 48077Prince Sultan Cardiac Center, Al Qassim, Kingdom of Saudi Arabia.
- 14Department of Cardiology, 204603Prince Sultan Cardiac Center, Al Hassa, Kingdom of Saudi Arabia.
- 15Department of Emergency Medicine, 195017King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
- 16Department of Cardiology, 384526Baylor Scott & White The Heart Hospital, Plano, TX, USA.
- 17Department of Cardiovascular Medicine, 195017King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia.
- 18Department of Cardiovascular Medicine, 21645Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
Abstract
Data on spontaneous coronary artery dissection (SCAD) is based on European and North American registries. We assessed the prevalence, epidemiology, and outcomes of patients presenting with SCAD in Arab Gulf countries. Patients (n = 83) were diagnosed with SCAD based on angiographic and intravascular imaging whenever available. Thirty centers in 4 Arab Gulf countries (Kingdom of Saudi Arabia, United Arab Emirates, Kuwait, and Bahrain) were involved from January 2011 to December 2017. In-hospital (myocardial infarction [MI], percutaneous coronary intervention, ventricular tachycardia/fibrillation, cardiogenic shock, death, implantable cardioverter-defibrillator placement, dissection extension) and follow-up (MI, de novo SCAD, death, spontaneous superior mesenteric artery dissection) cardiac events were recorded. Median age was 44 (37-55) years, 42 (51%) were females and 28.5% were pregnancy-associated (21.4% were multiparous). Of the patients, 47% presented with non-ST-elevation acute coronary syndrome, 49% with acute ST-elevation myocardial infarction, 12% had left main involvement, 43% left anterior descending, 21.7% right coronary, 9.6% left circumflex, and 9.6% multivessel; 52% of the SCAD were type 1, 42% type 2, 3.6% type 3, and 2.4% multitype; 40% managed medically, 53% underwent percutaneous coronary intervention, 7% underwent coronary artery bypass grafting. Females were more likely than males to experience overall (in-hospital and follow-up) adverse cardiovascular events (P = .029).
Keywords: Arab Gulf; acute coronary syndrome; spontaneous coronary artery dissection.
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