{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T05:57:47Z","timestamp":1769579867598,"version":"3.49.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"\n Background:<\/jats:title>\n Atherosclerotic coronary plaque dissection (ACPD) is one cause of acute coronary syndrome (ACS) caused by underlying atherosclerosis. Spontaneous coronary artery dissection (SCAD) occurs outside the setting of atherosclerosis among young women and individuals with few or no conventional atherosclerotic risk factors, and has emerged as an important cause of ACS, and sudden death. A comparison between ACPD and SCAD has not been previously addressed in the literature. Our study will compare ACPD and SCAD.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Patients with confirmed diagnosis of SCAD and ACPD were retrospectively identified from 30 centers in 4 Arab Gulf countries between January 2011 and December 2017. In-hospital (ventricular tachycardia\/ventricular fibrillation, myocardial infarction (MI), percutaneous coronary intervention, dissection extension, cardiogenic shock, death, implantable cardioverter-defibrillator placement) and follow-up (MI, de novo SCAD, spontaneous superior mesenteric artery dissection, death) events were compared between them.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Eighty-three cases of SCAD and 48 ACPD were compared. ACPD patients were more frequently male (91.67% vs. 49.40%, P<\/jats:italic> < 0.001) and older (58.5 vs. 44, P<\/jats:italic> < 0.001). Cardiovascular risk factors were more prevalent in patients with ACPD, including diabetes mellitus (60.4% vs. 25.3%), dyslipidemia (62.5% vs. 38.5%), and hypertension (62.5% vs. 31.3%), P<\/jats:italic> < 0.001. Hospital presentation of ST-elevation MI was diagnosed in 48% of SCAD versus 27% of ACPD patients (P<\/jats:italic> = 0.012). SCAD patients received medical-only treatment in 40% of cases and ACPD in 21% (P<\/jats:italic> = 0.042). In-hospital and follow-up events were comparable in both groups (P<\/jats:italic> = 0.25).<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Despite a completely different pathophysiology of ACS between SCAD and ACPD, in-hospital and follow-up events were comparable.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/hpc.0000000000000233","type":"journal-article","created":{"date-parts":[[2020,7,13]],"date-time":"2020-07-13T03:00:30Z","timestamp":1594609230000},"page":"36-43","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Clinical Presentation and Outcome of Patients With Spontaneous Coronary Artery Dissection Versus Atherosclerotic Coronary Plaque Dissection"],"prefix":"10.1097","volume":"20","author":[{"given":"Amin","family":"Daoulah","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salem M.","family":"Al-Faifi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Madan","sequence":"additional","affiliation":[{"name":"Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr A.","family":"Arafat","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad S.","family":"Hersi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Sciences College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulaziz","family":"Alasmari","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis A.","family":"Clarkson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Ball","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Alkhushail","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdul Salim","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Prince Sultan Cardiac Center, Riyadh, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farhan M.","family":"Asrar","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine and Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada;"},{"name":"Credit Valley Family Medicine Teaching Unit and Summerville Family Medicine Teaching Unit, Trillium Health Partners and University of Toronto, Mississauga, Ontario, Canada;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ejazul","family":"Haq","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, King Faisal Specialist Hospital & Research Center, Jeddah, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Nabil","family":"Alama","sequence":"additional","affiliation":[{"name":"Department of Cardiology, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mazen S.","family":"Faden","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Critical Care Medicine, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Lotfi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2020,7,9]]},"reference":[{"key":"R1-20250506","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.jacc.2016.05.034","article-title":"Contemporary review on spontaneous coronary artery dissection.","volume":"68","author":"Saw","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"R2-20250506","doi-asserted-by":"crossref","first-page":"e523","DOI":"10.1161\/CIR.0000000000000564","article-title":"Spontaneous coronary artery dissection: current state of the science: a scientific statement from the American Heart Association.","volume":"137","author":"Hayes","year":"2018","journal-title":"Circulation"},{"key":"R3-20250506","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1161\/CIRCINTERVENTIONS.114.001760","article-title":"Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular 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long-term clinical outcome in a predominantly medically treated population.","volume":"89","author":"Rogowski","year":"2017","journal-title":"Catheter Cardiovasc Interv"},{"key":"R13-20250506","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1161\/CIR.0000000000000133","article-title":"2014 AHA\/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines.","volume":"130","author":"Amsterdam","year":"2014","journal-title":"Circulation"},{"key":"R14-20250506","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1093\/eurheartj\/ehv320","article-title":"2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European 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Global Utilization of Streptokinase and TPA for occluded arteries.","volume":"81","author":"Brieger","year":"1998","journal-title":"Am J Cardiol"},{"key":"R24-20250506","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1056\/NEJM199808133390704","article-title":"Inhibition of platelet glycoprotein IIb\/IIIa with eptifibatide in patients with acute coronary syndromes. The PURSUIT Trial Investigators. Platelet glycoprotein IIb\/IIIa in unstable angina: receptor suppression using integrilin therapy.","volume":"339","year":"1998","journal-title":"N Engl J Med"},{"key":"R25-20250506","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0735-1097(97)00118-6","article-title":"Influence of diabetes mellitus on clinical outcome in the thrombolytic era of acute myocardial infarction. GUSTO-I Investigators. Global utilization of streptokinase and tissue plasminogen activator for occluded coronary arteries.","volume":"30","author":"Mak","year":"1997","journal-title":"J Am Coll Cardiol"},{"key":"R26-20250506","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1016\/j.amjmed.2011.07.032","article-title":"Patients with acute coronary syndrome and normal high-sensitivity troponin.","volume":"124","author":"Meune","year":"2011","journal-title":"Am J Med"},{"key":"R27-20250506","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1001\/jama.295.13.joc60034","article-title":"Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial.","volume":"295","author":"Kastrati","year":"2006","journal-title":"JAMA"},{"key":"R28-20250506","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/S0140-6736(99)10285-X","article-title":"Troponin concentrations for stratification of patients with acute coronary syndromes in relation to therapeutic efficacy of tirofiban. 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