{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T22:57:41Z","timestamp":1793141861281,"version":"4.5.0"},"reference-count":27,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec id=\"ab-hoi260022-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction predominantly affecting women. There is a paucity of reproductive health data surrounding pregnancy-associated SCAD (P-SCAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi260022-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine detailed reproductive variables as well as demographics, psychosocial, and SCAD-event factors among women with a history of at least 1 prior pregnancy in a large, multicenter registry (iSCAD Registry).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi260022-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>\n                      This cohort study compared data of women with P-SCAD vs women with non\u2013pregnancy-associated SCAD (NP-SCAD) between the years 2019 and 2024 and rates of certain reproductive health features among the general reproductive-aged population in US states. Differences were analyzed using the Kruskal-Wallis test for continuous variables and \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      test for categorical variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi260022-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>Pregnancy and SCAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi260022-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Patient survey-based clinical and reproductive history variables were collected and corroborated with investigator-extracted clinical and imaging data, including detailed characterization of the SCAD event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi260022-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 907 women (median [IQR] age at enrollment, 52.0 [45.1-59.4] years; median [IQR] age at first SCAD event, 49.2 [42.3-57.1] years) with SCAD and 1 or more pregnancies, 98 had P-SCAD with median (IQR) age of 36.7 (33.7-39.1) years at time of SCAD event. Those with P-SCAD had a lower prevalence of fibromuscular dysplasia (27 of 86 [31%] vs 309 of 681 [45%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.01) but similar rates of extracoronary abnormalities. Greater use of assisted reproductive technology (ART; 25 of 97 [26%] vs 98 of 804 [12%]), greater multigravida with more than 5 gestations (13 of 98 [13%] vs 55 of 809 [7%]), and preeclampsia (24 of 98 [25%] vs 101 of 809 [13%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009= .001) were reported among women with P-SCAD. Those with P-SCAD had a more severe SCAD phenotype including higher incidence of STEMI (16 of 86 [18.6%] vs 40 of 733 [5.5%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&amp;amp;lt;\u2009.001), multivessel segment involvement (22 of 70 [31%] vs 101 of 588 [17%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009= .004), and left ventricular ejection fraction (LVEF) lower than 40% (4 of 15 [27%] vs 6 of 105 [7%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009= .006). They also experienced less LVEF recovery by 1-year follow-up. The majority (661 of 887 [75%]) of both groups were primarily medically managed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-hoi260022-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>From this large, multisite registry, results reveal that women with P-SCAD had greater median ages at gestation, greater history of ART use, and greater instances of multigravida and preeclampsia than women with NP-SCAD and the general reproductive-aged US population. With high percentages of vascular imaging among participants, women with P-SCAD had less fibromuscular dysplasia but similar rates of extracoronary abnormalities including dissection and aneurysms as women with NP-SCAD. In this contemporary cohort, women with P-SCAD continue to represent a higher-risk phenotype with predominantly conservative management; however, they had less LVEF recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamacardio.2026.1009","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T21:30:12Z","timestamp":1774819812000},"page":"534","source":"Crossref","is-referenced-by-count":8,"title":["Pregnancy-Associated Spontaneous Coronary Artery Dissection"],"prefix":"10.1001","volume":"11","author":[{"given":"Agnes","family":"Koczo","sequence":"first","affiliation":[{"name":"University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Grodzinsky","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Mid America Heart Institute\/University of Missouri-Kansas City, Kansas City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther S. 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