{"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":1788980377942,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Spontaneous coronary artery dissection (SCAD) predominantly affects women with limited data in men. We aimed to determine sex differences in SCAD presentation, associated conditions, and major adverse cardiovascular events (MACE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cohort study of 23 ANZ\u2010SCAD sites (Australian\/New Zealand Registry, data previously published) with core laboratory confirmed SCAD. Descriptive statistics for sex differences. Interaction analysis with Cox proportional hazards model assessed the effect of sex on previously published independent predictors of MACE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Of a total of 527 patients with SCAD, 468 (88.8%) were female. Mean age was similar, at 53.5\u00b110.6 in women and 52.2\u00b110.7 in men. Women had higher rates of hypertension (30.6% versus 16.9% men,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.044). Emotional stress as a SCAD precipitant was documented in the medical records in more women (16.0% versus 2.9% men,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.042) with no difference when self\u2010reported (60.6% women versus 54.2% men,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.715). Women were more likely to have moderate\/severe coronary tortuosity (55.0% versus 34.6% men,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.009). Fibromuscular dysplasia (FMD) was detected in 24.2% versus 16.7% (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.612) and non\u2010FMD vascular abnormalities in 4.0% versus 16.7% (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.027) of women versus men screened. There was no sex difference in 3\u2010year MACE; 8.2% women, 11.9% men (log\u2010rank\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.2). There was no interaction by sex (all\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      values &gt;0.05) with variables associated with increased MACE, namely oral anticoagulation, dual antiplatelet therapy comprising aspirin and ticagrelor, FMD, and previous stroke.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Women with SCAD had higher rates of hypertension, coronary tortuosity, and FMD, whereas men had more non\u2010FMD vascular abnormalities. Self\u2010reported emotional stress was common, equally prevalent in women and men. Anticoagulation, dual antiplatelet therapy, FMD, and previous stroke were independent predictors of MACE in both women and men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/anzctr.org.au\/Trial\/Registration\/TrialReview.aspx?ACTRN=12621000824864\">https:\/\/anzctr.org.au\/<\/jats:ext-link>\n                      ; Unique Identifier: 12621000824864.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.042260","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T10:22:13Z","timestamp":1772101333000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Spontaneous Coronary Artery Dissection: Sex Differences in Clinical Presentation and Outcomes From the Australian New Zealand Registry"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0497-2694","authenticated-orcid":false,"given":"Fergal T.","family":"Temple","sequence":"first","affiliation":[{"name":"University of Sydney","place":["Australia"]},{"name":"University of Sydney","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0309-1289","authenticated-orcid":false,"given":"Quan","family":"Dang","sequence":"additional","affiliation":[{"name":"University of 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Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0222-5468","authenticated-orcid":false,"given":"Peter J.","family":"Psaltis","sequence":"additional","affiliation":[{"name":"The University of Adelaide","place":["Australia"]},{"name":"South Australian Health and Medical Research Institute","place":["Adelaide, Australia"]},{"name":"Central Adelaide Local Health Network","place":["Adelaide, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5818-8024","authenticated-orcid":false,"given":"Leonard","family":"Kritharides","sequence":"additional","affiliation":[{"name":"University of Sydney","place":["Australia"]},{"name":"ANZAC Medical Research Institute","place":["Sydney, Australia"]},{"name":"Sydney Local Health District","place":["Sydney, 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