Spontaneous Coronary Artery Dissection In The Gulf: The G-SCAD Registry

Background
The available data on spontaneous coronary artery dissection (SCAD) has been based on registries from Europe and North America. The purpose of this study was to assess the incidence, epidemiology, and outcomes of patients presenting with SCAD in the Gulf region.

Methods
131 patients with confirmed diagnosis of SCAD were identified in 30 centers, out of 4 Gulf countries (KSA, UAE, Kuwait, and Bahrain), between January 2011 and December 2017. Patients were diagnosed with SCAD based on angiographic and intravascular imaging modalities. Several variables and related factors were evaluated. Short-term ( VT/VF, cardiogenic shock, death, MI, PCI, dissection extension) and long-term (VT/VF, death, MI, de novo SCAD) events were recorded.

Results
Mean age was 49, 65% were males and 35% were females. No patients had fibromuscular dysplasia. 26% of the female patients were pregnant or postpartum. 52% of the patients presented with an acute coronary syndrome and 41% presented with acute ST-segment elevation myocardial infarction. 10% had left main involvement, 39% had LAD, 29% had RCA, 8% had LCX, and 8% had multivessel. 47% of the SCAD were type 1, 40% were type 2, and 6% were type 3. 33% were managed medically, 56% underwent PCI and 11% underwent CABG. Females were more likely than males to experience short-term and long-term events (P=0.017).

Conclusions
This study sheds light on the epidemiology of SCAD in the Gulf region. In this registry, SCAD affected predominantly males. However, females had more events