SCAD Description and Management
The SCAD Research Program's study on description and management of SCAD utilizes data from Mayo Clinic's SCAD registry to identify patterns among participants with confirmed SCAD. The research team is looking at:
- The incidence of each participant's SCAD
- Clinical characteristics
- Treatment received
- In-hospital outcomes
- 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, more men than women experienced extreme exertion when their SCAD occurred.
- A large proportion of patients have fibromuscular dysplasia (FMD).
- Some women had recently given birth.
- Nearly a quarter of participants 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 strategies are often preferred when possible, as SCAD can heal. However, patients receiving conservative management strategies should be monitored because some will have progression of SCAD requiring intervention. Percutaneous coronary intervention is appropriate if a patient is unstable or is having progressive SCAD or both.
To better understand the long-term risk of recurrence, Mayo researchers conduct follow-ups with participants in the years after their SCAD. In these follow-ups, about 15 percent of participants have had a recurrence of SCAD. Program researchers estimate that the 10-year rate of major adverse cardiac events — including death, heart failure, myocardial infarction and SCAD recurrence — is even higher, emphasizing the need for close follow-up and care of those with SCAD.