{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T22:48:57Z","timestamp":1792363737371,"version":"4.4.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is underdiagnosed and an important cause of myocardial infarction in young women. The frequency of predisposing and precipitating conditions and cardiovascular outcomes remains poorly described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>Patients with NA-SCAD prospectively evaluated (retrospectively or prospectively identified) at Vancouver General Hospital were included. Angiographic SCAD diagnosis was confirmed by 2 experienced interventional cardiologists and categorized as type 1 (multiple lumen), 2 (diffuse stenosis), or 3 (mimic atherosclerosis). Fibromuscular dysplasia screening of renal, iliac, and cerebrovascular arteries were performed with angiography or computed tomographic angiography\/MR angiography. Baseline, predisposing and precipitating conditions, angiographic, revascularization, in-hospital, and long-term events were recorded. We prospectively evaluated 168 patients with NA-SCAD. Average age was 52.1\u00b19.2 years, 92.3% were women (62.3% postmenopausal). All presented with myocardial infarction. ECG showed ST-segment elevation in 26.1%, and 3.6% had ventricular tachycardia\/ventricular fibrillation arrest. Fibromuscular dysplasia was diagnosed in 72.0%. Precipitating emotional or physical stress was reported in 56.5%. Majority had type 2 angiographic SCAD (67.0%), only 29.1% had type 1, and 3.9% had type 3. The majority (134\/168) were initially treated conservatively. Overall, 6 of 168 patients had coronary artery bypass surgery and 33 of 168 had percutaneous coronary intervention in-hospital. Of those treated conservatively (n=134), 3 required revascularization for SCAD extension, and all 79 who had repeat angiogram \u226526 days later had spontaneous healing. Two-year major adverse cardiac events were 16.9% (retrospectively identified group) and 10.4% (prospectively identified group). Recurrent SCAD occurred in 13.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Majority of patients with NA-SCAD had fibromuscular dysplasia and type 2 angiographic SCAD. Conservative therapy was associated with spontaneous healing. NA-SCAD survivors are at risk for recurrent cardiovascular events, including recurrent SCAD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.114.001760","type":"journal-article","created":{"date-parts":[[2014,10,8]],"date-time":"2014-10-08T01:05:11Z","timestamp":1412730311000},"page":"645-655","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":668,"title":["Spontaneous Coronary Artery Dissection"],"prefix":"10.1161","volume":"7","author":[{"given":"Jacqueline","family":"Saw","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eve","family":"Aymong","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Sedlak","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher E.","family":"Buller","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Starovoytov","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Ricci","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Robinson","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tycho","family":"Vuurmans","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Gao","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Humphries","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.B. John","family":"Mancini","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Vancouver General Hospital, Vancouver, BC (J.S., T.S., A.S., D.R., G.B.J.M.); Division of Cardiology, St Paul\u2019s Hospital, Vancouver, BC (E.A.); Division of Cardiology, St Michael\u2019s Hospital, Toronto, Ontario (C.E.B.); Division of Cardiology, Royal Jubilee Hospital, Victoria, BC (S.R.); Division of Cardiology, Royal Columbian Hospital, New Westminster, BC (T.V.); and BC Centre for Improved Cardiovascular Health, UBC, Vancouver, BC (M.G., K.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.22115"},{"key":"e_1_3_3_3_2","article-title":"Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome [published online ahead of print September 11, 2013].","author":"Nishiguchi T","unstructured":"Nishiguchi T, Tanaka A, Ozaki Y, Taruya A, Fukuda S, Taguchi H, Iwaguro T, Ueno S, Okumoto Y, Akasaka T. 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Obstet Gynecol. 1972;40:202\u2013210.","journal-title":"Obstet Gynecol"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2013.10.003"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(01)02272-X"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.013"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.114.001760","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:56:51Z","timestamp":1715554611000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.114.001760"}},"subtitle":["Association With Predisposing Arteriopathies and Precipitating Stressors and Cardiovascular Outcomes"],"short-title":[],"issued":{"date-parts":[[2014,10]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2014,10]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.114.001760"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.114.001760","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,10]]},"assertion":[{"value":"2014-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-09-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-10-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}