SCAD Description and Management

This study utilizes data from the Mayo Clinic SCAD registry to identify patterns among participants with angiographically confirmed SCAD. The research team is looking at the incidence of each participant's SCAD, clinical characteristics, treatment received, in-hospital outcomes, and long-term risk of SCAD recurrence or major adverse cardiac events.

The study has already identified a number of salient clinical features of SCAD. For example, in the initial group of participants, many more men than women experienced extreme exertion when their SCAD occurred. A significant percentage of the women had recently given birth. Approximately half of the participants experienced heart attack symptoms, and nearly a quarter had SCAD in more than one blood vessel.

The research team is also evaluating strategies for managing SCAD. Coronary artery bypass grafting is the least commonly employed strategy, and has thus far been associated with few complications. Conservative management strategies are more common, as is percutaneous coronary intervention. Conservative strategies do not appear to be associated with higher levels of complications, but participants who were treated with percutaneous coronary intervention have experienced more complications and even death.

To better understand the long-term risk of recurrence, Mayo researchers conduct follow-ups with participants in the years following their SCAD. In these follow-ups, about 20 percent of participants have thus far reported a recurrence of SCAD; all of these participants have been female. We currently estimate that the 10-year rate of major adverse cardiac events, including death, heart failure, myocardial infarction and SCAD recurrence, is near 50 percent, demonstrating that close follow-up of SCAD survivors is crucial.

Initial findings from this project have been published. Research in this area is ongoing.