{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:59:37Z","timestamp":1788980377215,"version":"build-2803163510"},"reference-count":67,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite recent advancements in the recognition and diagnosis of spontaneous coronary artery dissection (SCAD), pathophysiologic mechanisms, predisposing and precipitating factors, risk of recurrences remain poorly understood and evidence\u2010based treatment strategies are still unavailable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The goals of the study are to assess the characteristics of SCAD patients highlighting the predisposing and precipitating factors, to analyse the therapeutic management in the acute phase, to evaluate the incidence of SCAD recurrence and cardiovascular events during the follow\u2010up and to assess the factors influencing the quality of life of patients after a SCAD event. We also aim to introduce our experience about the use of intra\u2010aortic balloon pump in acute SCAD setting in order to support the percutaneous coronary intervention (PCI) or its use as part of a conservative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective, single\u2010center, observational cohort study of patients with non\u2010atherosclerotic, non\u2010iatrogenic SCAD presenting to our Cath Lab in Santa Maria Annunziata Hospital (Bagno a Ripoli, Florence, Italy) with acute coronary syndrome (ACS). We enrolled 84 patients who presented with acute coronary syndrome and SCAD documented by coronary angiography or intracoronary imaging, from January 2015 to December 2024. We excluded patients with iatrogenic dissection and coronary atherosclerotic disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 56.2\u2009\u00b1\u200911.6 years and 79 (94%) patients were women. At baseline, 40% had hypertension, 38.8% dyslipidaemia, 29.4% was current smoker, only 2.4% had diabetes mellitus. The most frequent hospital presentation was NSTEMI (70,6%), followed by STEMI (28,2%) and ventricular tachycardia or ventricular fibrillation (3.5%). Majority of SCAD involved a single coronary artery territory (89.3%), and the most common coronary artery dissected was the left anterior descending artery and its branches (40.5%).<\/jats:p>\n                    <jats:p>\n                      Majority of patients (82%) were treated conservatively as initial strategy; 15 patients (18%) underwent myocardial revascularization with PCI or coronary artery bypass grafting (CABG). In nine cases (10.6%) IABP was implanted to perform a protect PCI (4.8%), as bridge to emergency CABG in course of hemodynamic instability (2.4%) or as part of conservative management (3.6%) avoiding coronary instrumentation and PCI with positive long\u2010term outcome. During the follow\u2010up period (median follow\u2010up 2.6 years with interquartile range 1.1\u20135.4 years) the primary endpoint, defined as major adverse cardiovascular events (MACE) incidence and new onset or recurrence of atrial fibrillation (AF), occurred in 18 patients (21.4%). Hypertension emerged as independent predictor of primary outcome (\n                      <jats:italic>p<\/jats:italic>\n                      0.001, HR 7.965) and low\u2010dosage aspirin at discharge appeared to be protective reducing risk of primary outcome (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, HR 0.0034). The secondary outcome was to evaluate quality of life (QoL) of patients who suffered SCAD using EQ\u20105D\u20105L questionnaire and Seattle Angina Questionnaire\u20107. No significative differences emerged between patients treated by PCI and patients treated conservatively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In SCAD patients, hypertension increases risk of primary outcome while low\u2010dosage aspirin reduces risk during follow\u2010up period. In terms of quality of life and post\u2010SCAD chest pain, no significative differences emerged between patients treated by PCI and patients treated conservatively.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70232","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T03:52:28Z","timestamp":1760673148000},"page":"3819-3836","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Spontaneous Coronary Artery Dissection: Cardiovascular Events Incidence and Quality of Life Evaluation in a Single\u2010Center 10 Years' Experience"],"prefix":"10.1002","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9718-8880","authenticated-orcid":false,"given":"Noemi","family":"Cenni","sequence":"first","affiliation":[{"name":"Department of Interventional Cardiology Santa Maria Annunziata Hospital Florence Italy"},{"name":"Department of Interventional Cardiology Careggi Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piercarlo","family":"Ballo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Santa Maria Annunziata Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Chechi","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Santa Maria Annunziata Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Rosso","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Santa Maria Annunziata Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Vivalda","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Santa Maria Annunziata Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Di Mario","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology Careggi Hospital Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.084"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872613504310"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy080"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012570"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.02.040"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001209"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002054"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz007"},{"key":"e_1_2_12_10_1","first-page":"1","article-title":"Current Contraceptive Status Among Women Aged 15\u201049: United States, 2015\u20132017","volume":"327","author":"Daniels K.","year":"2018","journal-title":"NCHS Data Brief"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318265df42"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2019.0774"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.05.055"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.04.019"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000442577.96802.8c"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.03.011"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.105718"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001760"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000564"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-8807(01)00074-6"},{"key":"e_1_2_12_21_1","article-title":"Spontaneous Coronary Artery Dissection Associated With Anal Cancer Management With Fluorouracil and Radiotherapy","volume":"11","author":"Hart K.","year":"2019","journal-title":"Cureus"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588-023-01410-1"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-022-01075-x"},{"issue":"1","key":"e_1_2_12_24_1","article-title":"Recent Advances on the Genetics of Spontaneous Coronary Artery Dissection","volume":"15","author":"Tweet M. S.","year":"2022","journal-title":"Circulation: Genomic and Precision Medicine"},{"issue":"9","key":"e_1_2_12_25_1","first-page":"929","article-title":"Burden of Rare Genetic Variants in Spontaneous Coronary Artery Dissection","volume":"7","author":"Goel R.","year":"2022","journal-title":"JAMA Cardiology"},{"issue":"2","key":"e_1_2_12_26_1","article-title":"Dissecting the Genomics of Spontaneous Coronary Artery Dissection","volume":"15","author":"Adlam D.","year":"2022","journal-title":"Circulation: Genomic and Precision Medicine"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.118.006772"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2019.01.015"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.03.039"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.01.188"},{"issue":"14","key":"e_1_2_12_31_1","first-page":"1651","article-title":"Spontaneous Coronary Artery Dissection: No Longer a Rare Disease","volume":"74","author":"Adlam D.","year":"2019","journal-title":"Journal of the American College of Cardiology"},{"issue":"3","key":"e_1_2_12_32_1","article-title":"Natural History and Vascular Health After Spontaneous Coronary Artery Dissection","volume":"11","author":"Tweet M. S.","year":"2018","journal-title":"Circulation: Cardiovascular Intervention"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2016.09.005"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25293"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.034"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001676"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.06.026"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(01)02272-X"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2013.02.010"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.110.959593"},{"issue":"2","key":"e_1_2_12_41_1","first-page":"133","article-title":"Spontaneous Coronary Artery Dissection: Novel Insights on Diagnosis and Management","volume":"5","author":"Alfonso F.","year":"2015","journal-title":"Cardiovascular Diagnosis and Therapy"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.053"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2011.08.013"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2011.01.012"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181d4b618"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.01.009"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.06.011"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.12.011"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001659"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCA.0000000000000412"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad191"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz048"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25293"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.06.014"},{"issue":"7","key":"e_1_2_12_55_1","first-page":"906","article-title":"Coronary Artery Bypass Surgery for Spontaneous Coronary Artery Dissection: The Mayo Clinic Experience","volume":"89","author":"Eleid M. F.","year":"2014","journal-title":"Mayo Clinic Proceedings"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2024.101385"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab372"},{"key":"e_1_2_12_58_1","volume-title":"Spontaneous Coronary Artery Dissection: Principles of Management","author":"Cleveland Clinic Journal of Medicine","year":"2023"},{"issue":"11","key":"e_1_2_12_59_1","first-page":"1141","article-title":"Natural History of Spontaneous Coronary Artery Dissection: Insights From a Large Prospective Series","volume":"10","author":"Saw J.","year":"2017","journal-title":"Journal of the American College Cardiovascular Interventions"},{"issue":"4","key":"e_1_2_12_60_1","first-page":"200","article-title":"Pregnancy\u2010Related Spontaneous Coronary Artery Dissection: Insights and Challenges","volume":"2","author":"Macaya F.","year":"2023","journal-title":"Nature Cardiovascular Research"},{"key":"e_1_2_12_61_1","article-title":"SCAD: Differences Between STEMI and NSTEMI Presentations","volume":"10","author":"L\u00f3pez\u2010Palop R.","year":"2023","journal-title":"Frontiers in Cardiovascular Medicine"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2011.0312"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.08.045"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjcn\/zvac009"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jscai.2024.101337"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(22)03868-2"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jccase.2021.01.004"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2022.09.032"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70232","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70232","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70232","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:22:35Z","timestamp":1784679755000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70232"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":67,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/ccd.70232"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70232","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]},"assertion":[{"value":"2025-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}