Understanding spontaneous coronary artery dissection (SCAD)
The goal of the Mayo Clinic SCAD Research Program is to advance the understanding of the underlying causes and risk factors for this poorly understood condition and develop solutions for optimal diagnosis, treatment and prevention.
Studying the genes that cause SCAD
The SCAD Research Program's DNA and plasma biobank allows the research team to perform DNA exome sequencing to identify the inherited and novel genetic mutations that underlie SCAD.
Imaging shows clues to SCAD risk factors
Clinical findings suggest that patients with SCAD have abnormalities in coronary architecture that predispose them to the disease. By identifying these abnormalities, the research team hopes to find clues about why SCAD happens and help identify high-risk patients. The optical coherence tomography (OCT) image above is of a coronary artery lumen with hematoma in the artery wall (12 to 2 o'clock).
The Mayo Clinic SCAD Research Program was created in response to data collection and a research agenda initiated by SCAD survivors via social networking. The program's unique approach includes using registries, participant data, genetic research, medical imaging and other collaborative studies.
SCAD and FMD
The SCAD Research Program's novel screening protocol helps researchers detect fibromuscular dysplasia (FMD) and other extracoronary abnormalities in patients with SCAD and assess the association between the two conditions.
Research integrated with patient care
For diagnosis, treatment and rehabilitation after a SCAD occurrence, Mayo Clinic has developed the multidisciplinary SCAD Clinic.
What is SCAD?
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of heart attack, but it remains poorly understood. The demographics of SCAD differ markedly from that of typical atherosclerotic heart attacks, in that most patients with SCAD are healthy young women who do not have conventional risk factors for heart disease.
The prevalence, causes, prognosis, recurrence rate and optimal management of SCAD are uncertain, with limited evidence available to guide medical professionals caring for patients with SCAD. Even fewer accessible and reliable sources of information are available to patients and families. Although work published by Mayo Clinic SCAD experts has been practice-changing, much remains to be learned.
SCAD Fundamentals, Care and Research at Mayo Clinic
About the SCAD Research Program
Mayo Clinic's Spontaneous Coronary Artery Dissection (SCAD) Research Program is part of an innovative multidisciplinary collaborative research and clinical practice initiative formed in 2010. The goal of the program is to advance the understanding of the underlying causes and risk factors for SCAD and develop solutions for optimal diagnosis, treatment and prevention.
The international Mayo Clinic SCAD Research Program was created in response to data collection and a research agenda initiated by SCAD survivors via social networking. The study population is the largest known SCAD registry in the world. Active recruitment continues via social media, physician referrals and other methods.
The program takes a novel approach to patient-initiated rare disease research, utilizing registries, comprehensive review of participant data, genetic analyses, advanced medical imaging and other collaborative studies. The research is based on a novel database registry and a DNA and plasma biobank. This approach, involving research colleagues from across Mayo and at select organizations, has already had an impact on the care of patients with SCAD.
The overarching goal of SCAD research at Mayo Clinic is to better characterize the pathophysiology and genetic basis of SCAD and guide optimal treatments. The research program continually builds upon its preliminary work and findings and its clinical expertise. Through cross-disciplinary collaboration, Mayo researchers seek to inspire hope and to contribute to the health and well-being of patients with SCAD through integrated clinical practice, education and research.
In close collaboration with patients and research participants, the SCAD research team hopes to generate new knowledge that will provide people with SCAD, their families and their health care providers with answers to the fundamental and critical questions that must be addressed to confidently guide decisions and deliver optimal health care.
The Mayo Clinic SCAD registry includes thorough demographic information and exhaustive clinical data, including patient-centered outcomes, for more than 1,000 participants with confirmed SCAD. Additional participants have been screened, had their SCAD diagnosis confirmed, and formally consented to the study, but are missing key data. The research team continues to work to complete these patients' records.
The SCAD Research Program has enrolled almost three times the originally estimated number of participants, which had been based on historical prevalence data, demonstrating that SCAD is not so much a rare condition as a severely underdiagnosed one.
The DNA and plasma biobank is composed of samples from almost 1,000 patients with SCAD and nearly 500 of their parents. Genetic SCAD research is aimed at identifying inherited and spontaneous mutations that underlie SCAD.
The Mayo Clinic SCAD Research Program's newsletter provides participants with information about the current status of the program, ongoing research projects, new discoveries since the program began and more.
Read the SCAD newsletter (PDF).