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@article{2251955,
author = {Chan, Nathan and Premawardhana, Diluka and AlandHussaini, Abtehale and Wood, Alice and Bountziouka, Vasiliki and Kotecha, Deevia and Swahn, Eva and Palmefors, Henning and Pagonis, Christos and Lawesson, Sofia Sederholm and Kadziela, Jacek and GarciaandGuimaraes, Marcos and Alfonso, Fernando and Escaned, Javier and Macaya, Fernando and Santas, Melisa and Cerrato, Enrico and Maas, Angela H E M and Hlinomaz, Ota and Bogale, Nigussie and Cortese, Bernardo and Cheng, Mavis and Bolger, Aidan and Hussain, Shazia T and Samani, Nilesh J and Knight, Marian and Cauldwell, Matthew and Adlam, David},
article_location = {Philadelphia},
article_number = {1},
doi = {http://dx.doi.org/10.1161/CIRCULATIONAHA.122.059635},
keywords = {coronary vessels; maternal death; myocardial infarction; pregnancy},
language = {eng},
issn = {0009-7322},
journal = {Circulation},
title = {Pregnancy and Spontaneous Coronary Artery Dissection: Lessons From Survivors and Nonsurvivors},
url = {https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.059635},
volume = {146},
year = {2022}
}
TY - JOUR
ID - 2251955
AU - Chan, Nathan - Premawardhana, Diluka - Al-Hussaini, Abtehale - Wood, Alice - Bountziouka, Vasiliki - Kotecha, Deevia - Swahn, Eva - Palmefors, Henning - Pagonis, Christos - Lawesson, Sofia Sederholm - Kadziela, Jacek - Garcia-Guimaraes, Marcos - Alfonso, Fernando - Escaned, Javier - Macaya, Fernando - Santas, Melisa - Cerrato, Enrico - Maas, Angela H E M - Hlinomaz, Ota - Bogale, Nigussie - Cortese, Bernardo - Cheng, Mavis - Bolger, Aidan - Hussain, Shazia T - Samani, Nilesh J - Knight, Marian - Cauldwell, Matthew - Adlam, David
PY - 2022
TI - Pregnancy and Spontaneous Coronary Artery Dissection: Lessons From Survivors and Nonsurvivors
JF - Circulation
VL - 146
IS - 1
SP - 69-72
EP - 69-72
PB - Lippincott Williams Wilkins
SN - 00097322
KW - coronary vessels
KW - maternal death
KW - myocardial infarction
KW - pregnancy
UR - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.059635
N2 - Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction associated with pregnancy (P-SCAD). It is also an understudied cause of maternal death. The present study aimed to report clinical presentation and management of P-SCAD in survivors and non-survivors and to investigate the outcome of pregnancies in women with previous SCAD. Patients were recruited from European SCAD registries with SCAD events from 1984 to 2021. All registries were approved by national or institutional ethical review boards. All patients gave written informed consent. The P-SCAD case series consisted of 82 patients (median age, 36 years [interquartile range, 5]; 94% never/former smokers, 85% White, 15% with hypertension, 5% with diabetes, 13% with dyslipidemia, 2% with previous stroke, 22% with family history of coronary artery disease,16% with extracoronary arteriopathies, and 48% with incomplete screening). Patients were alive at the time of enrollment and presented with SCAD confirmed on invasive angiography occurring during pregnancy or within 12 months of delivery, miscarriage, or termination. The pregnancy after previous SCAD series consisted of 37 pregnancies in 28 patients with angiographically confirmed SCAD who reported a subsequent pregnancy, whether ending in live birth, miscarriage, or termination. Data on 13 patients who did not survive P-SCAD were collected from the MBRRACE-UK audit of maternal deaths. The timing of SCAD in the P-SCAD case series is shown in the Figure. Few (n = 5) SCAD events occurred during pregnancy, with the peak time of vulnerability the first month after delivery. One patient had P-SCAD 4 months after miscarriage during her first trimester. Another had P-SCAD 3 weeks after medical termination.
ER -
CHAN, Nathan, Diluka PREMAWARDHANA, Abtehale AL-HUSSAINI, Alice WOOD, Vasiliki BOUNTZIOUKA, Deevia KOTECHA, Eva SWAHN, Henning PALMEFORS, Christos PAGONIS, Sofia Sederholm LAWESSON, Jacek KADZIELA, Marcos GARCIA-GUIMARAES, Fernando ALFONSO, Javier ESCANED, Fernando MACAYA, Melisa SANTAS, Enrico CERRATO, Angela H E M MAAS, Ota HLINOMAZ, Nigussie BOGALE, Bernardo CORTESE, Mavis CHENG, Aidan BOLGER, Shazia T HUSSAIN, Nilesh J SAMANI, Marian KNIGHT, Matthew CAULDWELL and David ADLAM. Pregnancy and Spontaneous Coronary Artery Dissection: Lessons From Survivors and Nonsurvivors. \textit{Circulation}. Philadelphia: Lippincott Williams Wilkins, 2022, vol.~146, No~1, p.~69-72. ISSN~0009-7322. Available from: https://dx.doi.org/10.1161/CIRCULATIONAHA.122.059635.
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