Turk Kardiyoloji Dernegi Arsivi, cilt.34, sa.5, ss.284-287, 2006 (Scopus)
Objectives: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary artery syndromes and sudden death. We evaluated characteristics of patients who were found to have SCAD at coronary angiography. Study design: We reviewed 32,000 coronary angiographies performed in a five-year duration and detected SCAD in 24 patients (0.07%; 22 males, 2 females; mean age 54 years; range 35 to 72 years). Clinical and angiographic findings of these patients were evaluated. Results: Of 24 patients with SCAD, eight patients (33.3%) had no coronary artery disease (CAD), whereas 16 patients (66.7%) had CAD of varying severity. Two or more risk factors were detected in 66.7% and 33.3% of patients with or without CAD, respectively. Dissections were found in the left coronary artery in 17 cases (70.8%), left anterior descending artery in four cases (16.7%), and circumflex artery in three cases (12.5%). Fourteen patients had no restriction in flow, so they received medications including aspirin, nitroglycerin, beta-blocker, ACE inhibitor, and a statin. Five patients underwent emergency coronary bypass surgery, four patients underwent primary stenting, and one patient received thrombolytic treatment. No complications were encountered during hospitalization. Conclusion: Detection of CAD of varying severity or multiple cardiovascular risk factors in most of the patients may imply the need for considering coronary atherosclerosis among classical risk factors for SCAD.