title: Gender differences and predictors of mortality in spontaneous coronary artery dissection: a review of reported cases.
abstract: Spontaneous coronary artery dissection (SCAD) is a rare clinical event with little available information on etiology, treatment, or outcomes. Two cases of SCAD are presented and identified cases from the literature with complete data (n = 222) are reviewed and analyzed. Female patients (71.9%) were younger (40.4 versus 46.7; p < 0.001), less likely to have coronary artery disease (3.7 versus 20.6%; p = 0.01), more likely to have left anterior descending artery (46.4 versus 25.4%; p = 0.004) and left main artery involvement (14.9 versus 3.2%; p = 0.01), and less likely to survive (50.9 versus 22.2%; p < 0.001) compared to their male counterparts. Thirty percent were in the peripartum state. Multivariate predictors of death included female sex (OR 4.27; 95% CI 1.50 to 12.2), non-treatment (OR 35.5; 95% CI 10.7 to 118.1), and earlier decade of diagnosis (OR 0.28 per increase in decade after 1980; 95% CI 0.16 to 0.49). Survival was no different by treatment type and did improve over time.
authors.affiliation: Division of Cardiovascular Services, Marsall University, Huntington, West Virginia 25702, USA. snowtoo@adelphia.net
authors.forename: Ellen A
authors.initials: EA
authors.lastname: Thompson
authors.forename: SueEllen
authors.initials: S
authors.lastname: Ferraris
authors.forename: Todd
authors.initials: T
authors.lastname: Gress
authors.forename: Victor
authors.initials: V
authors.lastname: Ferraris
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality*; D006328:Cardiac Catheterization; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000401:mortality*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012737:Sex Factors