{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T23:03:56Z","timestamp":1762211036010,"version":"3.37.3"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T00:00:00Z","timestamp":1666483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Spontaneous coronary artery dissection (SCAD) is often treated conservatively due to revascularization risks. Yet, an important number of SCAD patients have high acuity characteristics necessitating revascularization, with uncertain long\u2010term outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Document revascularization utilization and long\u2010term outcomes in high acuity SCAD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective\/retrospective analysis of consecutive patients with acute myocardial infarction (AMI) due to first SCAD event presenting directly to the Minneapolis Heart Institute 2002\u22122021, median follow\u2010up 3.8 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 139 patients (age 49\u2009\u00b1\u200912 years, 96% female), revascularization was performed in 60 (43%), utilizing percutaneous coronary intervention (PCI) (<jats:italic>n<\/jats:italic>\u2009=\u200956, successful in 80%) or coronary artery bypass graft (<jats:italic>n<\/jats:italic>\u2009=\u20094). In the entire cohort, 90 (65%) unique patients had one or more high acuity characteristic: ST\u2010elevation (38%), proximal dissection (38%), cardiogenic shock (6.5%), cardiac arrest (9.4%), left main dissection (6.5%), peripartum dissection (7.2%). High acuity patients accounted for 51 of 60 (85%) revascularizations. Revascularization rates were: ST\u2010elevation (60%), proximal dissection (62%), cardiogenic shock (89%), cardiac arrest (62%), left main dissection (100%), peripartum dissection (70%). Survival was 97% (revascularized) vs 100% (nonrevascularized); <jats:italic>p<\/jats:italic>\u2009=\u20090.2. Adverse outcomes (revascularized vs. nonrevascularized) included recurrent AMI:16.7% versus\u00a08.9%; <jats:italic>p<\/jats:italic>\u2009=\u20090.2, SCAD recurrence: 13.3% versus 6.3%; <jats:italic>p<\/jats:italic>\u2009=\u20090.1, stroke: 5% versus 2.5%; <jats:italic>p<\/jats:italic>\u2009=\u20090.44, implantable cardioverter\u2010defibrillator: 6.7% versus 6.3%; <jats:italic>p<\/jats:italic>\u2009&gt;\u20090.9. Reintervention was necessary in 21% of PCI\u2010treated patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>High\u2010acuity characteristics were present in nearly two\u2010thirds of this SCAD cohort; the vast majority of revascularizations were performed in high\u2010acuity patients. Despite high acuity, long\u2010term survival was favorable in revascularized patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30448","type":"journal-article","created":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T19:24:30Z","timestamp":1666553070000},"page":"1229-1241","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Revascularization and long\u2010term outcomes in high\u2010acuity spontaneous coronary artery dissection"],"prefix":"10.1002","volume":"100","author":[{"given":"Christina","family":"Thaler","sequence":"first","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawn R.","family":"Witt","sequence":"additional","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1123-0533","authenticated-orcid":false,"given":"Timothy D.","family":"Henry","sequence":"additional","affiliation":[{"name":"Lindner Center for Research and Education at The Christ Hospital Cincinnati Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth Z.","family":"Grey","sequence":"additional","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney J.","family":"Baechler","sequence":"additional","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Opema","family":"Lohese","sequence":"additional","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brynn K.","family":"Okeson","sequence":"additional","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian W.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7678-1742","authenticated-orcid":false,"given":"Scott W.","family":"Sharkey","sequence":"additional","affiliation":[{"name":"Penny Anderson Women's Cardiovascular Center at Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,10,23]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.034"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.105718"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.084"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2001524"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy080"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2014.01.011"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.694141"},{"key":"e_1_2_13_9_1","doi-asserted-by":"crossref","first-page":"e018551","DOI":"10.1161\/JAHA.120.018551","article-title":"Revascularization in patients with spontaneous coronary artery dissection: where are we now?","volume":"6","author":"Krittanawong C","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.06.026"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.116.004549"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jet015"},{"key":"e_1_2_13_13_1","first-page":"323","article-title":"Stent mal\u2010apposition with resportion of intramural hematoma with spontaneous coronary artery dissection","volume":"5","author":"Lempereur M","year":"2015","journal-title":"Cardiovasc Diagn 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MasottiM Sanz\u2010RuizR et al. 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Clinical outcomes in spontaneous coronary artery dissection.Heart.\u00a0Published online 2022.\u00a0doi:10.1136\/heartjnl\u20102022\u2010320830"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.318300"},{"key":"e_1_2_13_26_1","first-page":"1048","article-title":"American heart association council on peripheral vascular disease; American heart association council on clinical cardiology; American heart association council on cardiopulmonary, critical care, perioperative and resuscitation; American heart association council on cardiovascular disease in the young; American heart association council on cardiovascular radiology and intervention; American heart association council on epidemiology and prevention; American heart association council on functional genomics and translational biology; American heart association council for high blood pressure research; American heart association council on the kidney in cardiovascular disease; American heart association stroke council. fibromuscular dysplasia: state of the science and critical unanswered questions: a scientific statement from the American heart association","volume":"12","author":"Olin JW","year":"2014","journal-title":"Circulation"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30448","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.30448","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.30448","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T17:11:55Z","timestamp":1692551515000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.30448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,23]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1002\/ccd.30448"],"URL":"https:\/\/doi.org\/10.1002\/ccd.30448","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2022,10,23]]},"assertion":[{"value":"2022-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}