Spontaneous Coronary Artery Dissection: Does Being Unemployed Matter? Insights from the G-SCAD registry.

Al-Azizi, Karim

Spontaneous Coronary Artery Dissection: Does Being Unemployed Matter? Insights from the G-SCAD registry.

Monday, May 20, 2019

Belmont Ballroom 2-3 (The Cosmopolitan of Las Vegas)

Amin Daoulah , King Faisal Specialist hospital & research center, Jeddah, Saudi Arabia

Karim Al-Azizi, M.D., FSCAI , Heart Hospital Baylor Plano, Baylor Scott and White Healthcare System, Plano, TX

Ahmad S Hersi , King Saud University, Riyadh, Saudi Arabia

Alawi A Alsheikh-Ali , College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE; Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, UAE;, Dubai, Saudi Arabia

Adel Khalifa Hamad , Mohammed bin Khalifa Al Khalifa Cardiac Centre Bahrain Defence Force Hospital, Bahrain, Saudi Arabia

Mirvat Alasnag, M.D. , King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia

Mohammed Alshehri, M.D. , Prince Khaled bin Sultan cardiac center, Kamis Mushayet, Saudi Arabia

Ali Youssef Moustafa, M.D. , cardiology department, faculty of medicine, suez canal university, Ismailia, Egypt

Abdullah Alkhushail , Prince sultan cardiac center, Riyadh, Saudi Arabia

Salem M Al-Faifi , King Faisal Specialist hospital & research center, Jeddah, Saudi Arabia

Fahad Baslaib , Rashid Hospital, Dubai, Saudi Arabia

Mushabab Ayedh Al-Murayeh, M.B.B.S., FSCAI , Aseer Central Hospital, Khamis Mushayt, Saudi Arabia

Mohamed Maghrabi , Al Hada Military Hospital, Taif, Saudi Arabia

Sameer Alhamid , AlEman Hospital, Riyadh, Saudi Arabia

Saleh Al Khunein , Prince Sultan Military Medical City, Riyadh, Saudi Arabia

Khalid Omar Tammam, M.D. , The International Medical Center, Jeddah, Saudi Arabia

Jairam K Aithal , Burjeel Hospital, Abu Dhabi, United Arab Emirates

Mamdouh Morshid , King Abdullah Medical City, Makkah, Saudi Arabia

Nader Alasousi , Sabah Alahmad Cardiac Center , Amiri Hospital, Kuwait, Kuwait

Ziad Dahdouh , King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

Vikram Grewal , Baystate Medical Center, University of Massachusetts Medical School, Springfield, MA, Saudi Arabia

Vincent Balll , Cleveland Clinic foundation, Cleveland, OH

Bader Kassem Abumelha , forensic medicine center, Jeddah, Saudi Arabia

Zizi Saad , Aseer Central Hospital, Abha, Saudi Arabia

Amir Lotfi, M.D., FSCAI , Baystate Medical Center, Westfield, MA

Background
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome or sudden cardiac death. Physical and emotional stress have been identified as triggers for SCAD. However, the potential for over-reporting stress is important to consider. Unemployment has been linked to poor mental and physical health. The current study examined employment status and outcomes in patients with SCAD.

Methods
Data on 131 patients with a confirmed diagnosis of SCAD were collected retrospectively from 30 centers in 4 gulf countries (KSA, UAE, Kuwait and Bahrain) from January 2011 to December 2017. Short-term (VT/VF, cardiogenic shock, death, ICD placement, MI, PCI, dissection extension) and long-term (VT/VF, death, de novo SCAD, MI, spontaneous abdominal or mesenteric dissection) outcomes were compared among those who are employed and those who are not.

Results
The mean age was 49 years. 46 (35%) were women. Employment (government, private, or self-employed) was reported in 88 (67%) of all patients. The remaining 43 (33%) were unemployed. 80% of all men were employed and 65% of all women were unemployed (P<0.001). Compared with employment, unemployment was associated with a significant negative impact on outcomes (P=0.0018).

Conclusions
Short-term and long-term outcomes were significantly worse for patients with SCAD who were unemployed.