Focus Areas

Studies carried out in the Mayo Clinic SCAD Research Program involve evaluation of medical records and imaging data, patient narratives, and analysis of physical samples. These methods help the research team compile detailed assessments of participants' current mental and physical health and evaluate risk factors for recurrent SCAD.

Ongoing recruitment, data abstraction and reporting

The SCAD Research Program has been remarkably well-received by both patients and physicians. In response, research activities have been accelerated to meet current demand, engaging new research personnel and collaborators at Mayo and beyond.

Collecting relevant health information from individual participants is critical to proceeding with data abstraction and analysis, and the SCAD research team continues to work with participants and their health care providers to complete each participant's medical history. Active recruitment also continues via social media, physician referrals and other methods.

The information gathered from participants' medical records and narratives is crucial to all projects in the SCAD Research Program, but is particularly important to projects focused on:

Genetic research

To populate the DNA and plasma biobank, the research team performs DNA exome sequencing on samples provided by SCAD patients and one or both of their parents. Analysis of those samples is ongoing, with a long-term goal of identifying inherited and novel genetic mutations that underlie SCAD.

Evaluation of extracoronary vascular abnormalities in SCAD patients

Physical exams and medical imaging performed for other reasons on patients cared for in the SCAD clinic have revealed extracoronary vascular abnormalities, including fibromuscular dysplasia (FMD); aneurysms; dissections; and the presence of twisting, winding blood vessels (tortuosity). Mayo Clinic SCAD experts therefore advise patients to undergo vascular imaging as part of their medical evaluations in order to identify any coinciding vascular conditions.

The SCAD research team is retrospectively evaluating imaging performed both at Mayo Clinic and by participants' local health care providers in order to better understand the cause of SCAD, inform patient follow-up and determine how extracoronary vascular abnormalities affect outcomes.

Research in this area is being carried out in a project on:

Coronary artery imaging evaluations

The Mayo SCAD research team has extensive experience in interpreting coronary artery imaging in SCAD patients. Clinical findings suggest that patients with SCAD have abnormalities in underlying coronary architecture that predispose them to vessel wall dissection; these abnormalities may be similar to those found in patients with FMD. The team is working to identify these abnormalities, as they may provide clues to underlying mechanisms and help identify those at higher risk of recurrent events.

The research team has developed a unique CT protocol that maximizes convenience for patients while minimizing contrast, radiation, time and cost. However, more work remains to be done to determine the best imaging modality to identify these abnormalities, balancing risks such as radiation and contrast with accuracy and cost.

Research in this area is being carried out in a project on:

SCAD and mental health concerns

Depression and anxiety symptoms are common after a heart attack. In addition to adversely affecting patients' quality of life, these symptoms are associated with an increased risk of subsequent cardiac events.

The SCAD research team is studying whether anxiety and depression are more common among SCAD patients than among patients without heart disease or among those who have heart attacks due to atherosclerosis, for whom there is a much greater body of knowledge and many proven treatment options.

Research in this area is being carried out in a project on:

The future of SCAD research at Mayo Clinic

Early findings from clinical care and research have generated multiple substudies. The SCAD research team has grown to include Mayo Clinic radiologists, internal medicine and cardiology trainees, psychologists, obstetrician-gynecologists, and geneticists.

The team's early observations have raised many new questions and set the stage for numerous retrospective, prospective, clinical and genetic studies. Potential future studies and projects in the Mayo Clinic SCAD Research Program may include:

  • Genetic susceptibility for familial SCAD
  • The merits of revascularization as a strategy for acute management of SCAD
  • Improving the patient experience for SCAD diagnosis and follow-up
  • Cardiovascular rehabilitation after SCAD
  • Risks of pregnancy after SCAD
  • The role of noninvasive imaging in SCAD follow-up, including optimizing techniques to reduce ionizing radiation exposure
  • Coronary angiographic features in SCAD patients
  • Acquired and inherited monogenetic mutations in SCAD

Ultimately, the goal of the Mayo Clinic SCAD Research Program is to develop and lead multicenter trials to improve outcomes through better diagnostic tools, strategies for optimal acute treatment (at the time of the initial heart attack), and therapies for rehabilitation and prevention.