{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T22:01:25Z","timestamp":1784325685272,"version":"3.55.0"},"reference-count":13,"publisher":"IMR Press","issue":"3","license":[{"start":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T00:00:00Z","timestamp":1709596800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background: Spontaneous coronary artery dissection (SCAD) is defined as a non-traumatic separation of the epicardial coronary artery walls that creates a false lumen. SCAD poses a difficult challenge in management, as decisions regarding revascularization and medical management seem to be tailored to the individual patient. We evaluated and compared outcomes based on cardiogenic shock in patients with SCAD utilizing Nationwide Readmissions Database (NRD) between January 1, 2016, to December 30, 2020. Methods: We utilized the NRD 2016\u20132019 to carry out this study. We evaluated demographics (e.g., age, gender), conventional risk factors, comorbidities present on the index admission, and in-hospital outcomes using their specific ICD-10-CM codes. The primary outcomes were In-hospital mortality and 30-day readmission, and the secondary outcome was to compare the complications in SCAD patient with cardiogenic shock (CS) compared to those without CS. Results: We analyzed 2473 individuals with SCAD, 2199 of these individuals did not have cardiogenic shock whereas 274 of these individuals did have cardiogenic shock. When comparing SCAD with cardiogenic shock to SCAD without cardiogenic shock, there was a statistically significant increased odds ratio (OR) for death (propensity matched OR 24.93 (7.49\u201383.05), use of mechanical circulatory support (propensity matched OR 15.30 (6.87\u201334.04), ventricular tachycardia (propensity matched OR 4.45 (1.92\u201310.34), utilization of blood transfusions (propensity matched OR 3.82 (1.86\u20137.87), acute kidney injury (propensity matched OR 4.02 (1.45\u201311.13), need for mechanical ventilation (propensity matched OR 8.87 (3.53\u201322.31), and respiratory failure (propensity matched OR 4.95 (1.83\u201313.41)))))))). There was no statistically significant difference in 30-day readmission rates between the two groups. Conclusions: SCAD is a unique condition that can lead to many complications. In our analysis, we showed that SCAD associated with cardiogenic shock compared to SCAD not associated with cardiogenic shock results in greater odds of complications including death, use of mechanical circulatory support, need for blood transfusions, ventricular tachycardia, acute kidney injury, use of mechanical ventilation, and respiratory failure. SCAD with cardiogenic shock represents a significantly critical clinical scenario that requires a multi-disciplinary approach to prevent the many potential complications associated with this disease process.<\/jats:p>","DOI":"10.31083\/j.rcm2503086","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T08:17:42Z","timestamp":1709885862000},"source":"Crossref","is-referenced-by-count":4,"title":["Spontaneous Coronary Artery Dissection with Cardiogenic Shock in the United States"],"prefix":"10.31083","volume":"25","author":[{"given":"Chayakrit","family":"Krittanawong","sequence":"first","affiliation":[{"name":"Cardiology Division, NYU Langone Health and NYU School of Medicine, New York, NY 10016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhrubajyoti","family":"Bandyopadhyay","sequence":"first","affiliation":[{"name":"Department of Cardiology, Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA 02124, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelkumar","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Cardiology, Maimonides Medical Center, Brooklyn, NY 11219, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuf Kamran","family":"Qadeer","sequence":"first","affiliation":[{"name":"Section of Cardiology, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil Sagar","family":"Maitra","sequence":"first","affiliation":[{"name":"Division of Cardiology, Scripps Clinic, La Jolla, CA 92037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"first","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55902, USA"},{"name":"Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55902, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahboob","family":"Alam","sequence":"first","affiliation":[{"name":"The Texas Heart Institute, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samin","family":"Sharma","sequence":"first","affiliation":[{"name":"Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, New York, NY 10018, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Jneid","sequence":"first","affiliation":[{"name":"Division of Cardiology, University of Texas Medical Branch, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2024,3,5]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Saw J. 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Revascularization in Patients With Spontaneous Coronary Artery Dissection and ST-Segment Elevation Myocardial Infarction. Journal of the American College of Cardiology. 2019; 74: 1290\u20131300.","DOI":"10.1016\/j.jacc.2019.06.065"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Hayes SN, Tweet MS, Adlam D, Kim ESH, Gulati R, Price JE, et al. Spontaneous Coronary Artery Dissection: JACC State-of-the-Art Review. Journal of the American College of Cardiology. 2020; 76: 961\u2013984.","DOI":"10.1016\/j.jacc.2020.05.084"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Saw J, Aymong E, Sedlak T, Buller CE, Starovoytov A, Ricci D, et al. Spontaneous coronary artery dissection: association with predisposing arteriopathies and precipitating stressors and cardiovascular outcomes. Circulation. 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Journal of the American College of Cardiology. 2022; 80: 1585\u20131597.","DOI":"10.1016\/j.jacc.2022.08.759"}],"container-title":["Reviews in Cardiovascular Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/25\/3\/10.31083\/j.rcm2503086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T19:31:47Z","timestamp":1732735907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/RCM\/25\/3\/10.31083\/j.rcm2503086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,5]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"alternative-id":["S1530-6550(24)01317-6"],"URL":"https:\/\/doi.org\/10.31083\/j.rcm2503086","relation":{},"ISSN":["1530-6550","2153-8174"],"issn-type":[{"value":"1530-6550","type":"print"},{"value":"2153-8174","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,5]]},"article-number":"86"}}