Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association.
Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association.
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DOI：
10.1161/cir.0000000000000564
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发表时间：
2018-05-08
期刊：
影响因子：
37.8
通讯作者：
American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council
中科院分区：
文献类型：
--
作者：
Hayes SN;Kim ESH;Saw J;Adlam D;Arslanian-Engoren C;Economy KE;Ganesh SK;Gulati R;Lindsay ME;Mieres JH;Naderi S;Shah S;Thaler DE;Tweet MS;Wood MJ;American Heart Association Council on Peripheral Vascular Disease; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Genomic and Precision Medicine; and Stroke Council
自发性冠状动脉夹层（SCAD）已成为急性冠状动脉综合征、心肌梗死和猝死的重要原因，特别是在年轻女性和传统动脉粥样硬化危险因素很少的个体中。患者发起的研究促进了对SCAD的认识，提高了诊断能力，大型病例系列的发现导致了初始和长期管理方法的变化，越来越多的证据表明SCAD不仅比以前认为的更常见，而且必须与动脉粥样硬化性心肌梗死进行不同的评估和治疗。SCAD复发率高;其与女性性别、妊娠以及身体和情绪应激触发因素的关联;以及并发的全身性动脉病，特别是纤维肌性发育不良，突出了SCAD与动脉粥样硬化疾病相比在临床特征上的差异。最近的见解的原因，临床过程中，治疗方案，结果和相关条件的SCAD和许多持续的知识差距。
Spontaneous coronary artery dissection (SCAD) has emerged as an important cause of acute coronary syndrome, myocardial infarction, and sudden death, particularly among young women and individuals with few conventional atherosclerotic risk factors. Patient-initiated research has spurred increased awareness of SCAD, and improved diagnostic capabilities and findings from large case series have led to changes in approaches to initial and long-term management and increasing evidence that SCAD not only is more common than previously believed but also must be evaluated and treated differently from atherosclerotic myocardial infarction. High rates of recurrent SCAD; its association with female sex, pregnancy, and physical and emotional stress triggers; and concurrent systemic arteriopathies, particularly fibromuscular dysplasia, highlight the differences in clinical characteristics of SCAD compared with atherosclerotic disease. Recent insights into the causes of, clinical course of, treatment options for, outcomes of, and associated conditions of SCAD and the many persistent knowledge gaps are presented.