title: Prevalence of spontaneous coronary artery dissection in patients with acute coronary syndrome.
abstract: OBJECTIVE
  Spontaneous coronary artery dissection (SCAD) found typically in young females without classical coronary risk factors is thought to be a very rare cause of acute coronary syndrome (ACS). The prevalence of SCAD in ACS subjects has been unclear, probably due to the nature of coronary angiography. The aim of this study was to use optical coherence tomography (OCT) to investigate the prevalence of SCAD in ACS.
  
  
  RESULTS
  This study consisted of 326 patients with ACS (with or without ST-segment elevation) who underwent OCT to explore the entire culprit artery. According to OCT findings, patients were divided into a SCAD, a plaque rupture (PR), and a non-SCAD/non-PR group. OCT revealed 13 (4.0%) SCADs and 160 (49.1%) plaque ruptures in ACS subjects. The percentage of females versus males was greater in the SCAD group (SCAD: 53.8% vs. PR: 20.0% vs. non-SCAD/non-PR: 23.5%, p=0.02) while no difference was observed in age (SCAD: 67.3±13.3 vs. PR: 66.5±11.1 vs. non-SCAD/non-PR: 67.0±10.5, p=0.90). The prevalence of dyslipidemia (SCAD: 30.8% vs. PR: 63.8% vs. non-SCAD/non-PR: 67.5%, p=0.03) and current smoking (SCAD: 7.7% vs. PR: 57.9% vs. non-SCAD/non-PR: 59.7%, p<0.01) were significantly lower in the SCAD group.
  
  
  CONCLUSIONS
  SCAD is not a rare cause for ACS, especially in females without classical coronary risk factors.
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nishiguchi
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan a-tanaka@wakayama-med.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozaki
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Taruya
authors.affiliation: Department of Cardiovascular Medicine, Osaka Ekisaikai Hospital, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Fukuda
authors.affiliation: Department of Cardiovascular Medicine, Osaka Ekisaikai Hospital, Japan.
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Taguchi
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Iwaguro
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ueno
authors.affiliation: Department of Cardiovascular Medicine, Social Insurance Kinan Hospital, Tanabe, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okumoto
authors.affiliation: Department of Cardiovascular Medicine, Wakayama Medical University, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akasaka
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications*; D000368:Aged; D000369:Aged, 80 and over; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D014652:Vascular Diseases / Q000151:congenital* / Q000000981:diagnostic imaging / Q000453:epidemiology
keywords: OCT; Spontaneous coronary artery dissection; acute coronary syndrome