Outcomes of Primary Percutaneous Intervention for ST-Segment Elevation Myocardial Infarction With Versus Without Spontaneous Coronary Artery Dissection

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

American Journal of Cardiology Pub Date : 2025-03-17 DOI:10.1016/j.amjcard.2025.02.026

Abhishek Chaturvedi MD , Hector M. Garcia-Garcia MD, PhD , Matteo Cellamare PhD , Parul Chandrika MD , Waiel Abusnina MD , Cheng Zhang PhD , Ron Waksman MD

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引用次数: 0

Abstract

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome, but there is no clear consensus on the choice and timing of revascularization strategy. Recent data from outside the United States suggested similar inpatient mortality after primary percutaneous coronary interventions (PPCI) in patients presenting with ST-elevation myocardial infarction (STEMI) secondary to SCAD versus non-SCAD. Utilizing similar methodologies in a contemporary US cohort, we found that SCAD patients had higher inpatient mortality after PPCI for STEMI compared with non-SCAD patients. We also found that the SCAD group had prolonged hospitalization and hospitalization costs compared with on-SCAD patients. Furthermore, these trends have not changed over the past 5 years. Our findings reiterate the need for continued discussion and research on the role and timing of PPCI in SCAD-STEMI patients in well-designed prospective cohorts.

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经皮介入治疗st段抬高型心肌梗死伴与不伴自发性冠状动脉夹层的疗效比较。

自发性冠状动脉夹层（SCAD）是急性冠状动脉综合征的病因之一，但对于血管重建策略的选择和时机尚无明确的共识。最近来自美国以外的数据表明，继发于SCAD的st段抬高型心肌梗死（STEMI）患者在经皮冠状动脉介入治疗（PPCI）后的住院死亡率与非SCAD患者相似。在当代美国队列中使用类似的方法，我们发现SCAD患者在STEMI PPCI后的住院死亡率高于非SCAD患者。我们还发现，与非SCAD患者相比，SCAD组的住院时间更长，住院费用更高。此外，这些趋势在过去五年中没有改变。我们的研究结果重申，需要在设计良好的前瞻性队列中继续讨论和研究PPCI在SCAD-STEMI患者中的作用和时机。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Cardiology 医学-心血管系统

CiteScore

4.00

自引率

3.60%

发文量

698

审稿时长

33 days

期刊介绍： Published 24 times a year, The American Journal of Cardiology® is an independent journal designed for cardiovascular disease specialists and internists with a subspecialty in cardiology throughout the world. AJC is an independent, scientific, peer-reviewed journal of original articles that focus on the practical, clinical approach to the diagnosis and treatment of cardiovascular disease. AJC has one of the fastest acceptance to publication times in Cardiology. Features report on systemic hypertension, methodology, drugs, pacing, arrhythmia, preventive cardiology, congestive heart failure, valvular heart disease, congenital heart disease, and cardiomyopathy. Also included are editorials, readers'' comments, and symposia.