Sex differences in Spontaneous Coronary Artery Dissection: A Report of the iSCAD Registry

Lori Tam; Sahar Naderi; Malissa J. Wood; Gerald Chi; Heather L. Gornik; Bryan J. Wells; Daniella Kadian-Dodov; Anna Grodzinsky; Angela Taylor; Connie Ng Hess; Jennifer Lewey; Stanislav Henkin; James Langley Orford; Kathryn Lindley; Gretchen L. Wells; Rina Mauricio; C. Miachel Gibson; Katherine Leon; Soo Hyun Kim

doi:10.1016/S0735-1097(24)03140-1

Sex differences in Spontaneous Coronary Artery Dissection: A Report of the iSCAD Registry

Lori Tam, Sahar Naderi, Malissa J. Wood, Gerald Chi, Heather L. Gornik, Bryan J. Wells, Daniella Kadian-Dodov, Anna Grodzinsky, Angela Taylor, Connie Ng Hess, Jennifer Lewey, Stanislav Henkin, James Langley Orford, Kathryn Lindley, Gretchen L. Wells, Rina Mauricio, C. Miachel Gibson, Katherine Leon, Soo Hyun Kim

Research output: Other contribution

Abstract

Background

Spontaneous coronary artery dissection (SCAD) is a cause of myocardial infarction which most frequently affects perimenopausal women. To date, there is limited data regarding the characteristics of men who develop SCAD.

Methods

Detailed information regarding demographics, presenting characteristics, precipitating factors, and outcomes in males and females were obtained from the prospective, multicenter iSCAD Registry.

Results

Of 1,252 patients who experienced SCAD enrolled in the iSCAD Registry from 1/2019-9/2023, 80 (6.4%) were males. Mean age did not differ between sexes (females=49.7±10.4, males=50.2±10.3, p=0.792). Females more often reported emotional stress preceding SCAD. Males more often reported physical stress, both isometric and aerobic exertion. There were sex differences in symptoms, with females reporting a higher prevalence of non-chest discomfort, shortness of breath, and nausea/vomiting. Males had lower rates of autoimmune conditions, systemic inflammatory disorder, fibromuscular dysplasia, and migraine. Although in-hospital outcomes did not differ, length of stay was 6.1±19.0 days for females vs 3.8±2.4 days for males (p=0.003).

Conclusion

In a large US SCAD population, females more often reported emotional stress preceding SCAD while males reported physical exertion as a trigger. Females were more likely to present with non-chest discomfort symptoms. In-hospital outcomes were similar between sexes but length of stay was longer for females.

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Footnotes

Oral Contributions

B402

Sunday, April 7, 2024, 10:21 a.m.-10:31 a.m.

Session Title: Highlighted Original Research: Ischemic Heart Disease and the Year in Review

Abstract Category: 22. Ischemic Heart Disease: Clinical Science

Presentation Number: 906-08

Original language	Undefined/Unknown
DOIs	https://doi.org/10.1016/S0735-1097(24)03140-1
State	Published - Apr 1 2024

Publication series

Name	Articles, Abstracts, and Reports

Access to Document

10.1016/S0735-1097(24)03140-1License: Unspecified

http://digitalcommons.providence.org/publications/9437

Cite this

Tam, L., Naderi, S., Wood, M. J., Chi, G., Gornik, H. L., Wells, B. J., Kadian-Dodov, D., Grodzinsky, A., Taylor, A., Hess, C. N., Lewey, J., Henkin, S., Orford, J. L., Lindley, K., Wells, G. L., Mauricio, R., Gibson, C. M., Leon, K., & Kim, S. H. (2024, Apr 1). Sex differences in Spontaneous Coronary Artery Dissection: A Report of the iSCAD Registry. https://doi.org/10.1016/S0735-1097(24)03140-1

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abstract = "Background Spontaneous coronary artery dissection (SCAD) is a cause of myocardial infarction which most frequently affects perimenopausal women. To date, there is limited data regarding the characteristics of men who develop SCAD. Methods Detailed information regarding demographics, presenting characteristics, precipitating factors, and outcomes in males and females were obtained from the prospective, multicenter iSCAD Registry. Results Of 1,252 patients who experienced SCAD enrolled in the iSCAD Registry from 1/2019-9/2023, 80 (6.4%) were males. Mean age did not differ between sexes (females=49.7±10.4, males=50.2±10.3, p=0.792). Females more often reported emotional stress preceding SCAD. Males more often reported physical stress, both isometric and aerobic exertion. There were sex differences in symptoms, with females reporting a higher prevalence of non-chest discomfort, shortness of breath, and nausea/vomiting. Males had lower rates of autoimmune conditions, systemic inflammatory disorder, fibromuscular dysplasia, and migraine. Although in-hospital outcomes did not differ, length of stay was 6.1±19.0 days for females vs 3.8±2.4 days for males (p=0.003). Conclusion In a large US SCAD population, females more often reported emotional stress preceding SCAD while males reported physical exertion as a trigger. Females were more likely to present with non-chest discomfort symptoms. In-hospital outcomes were similar between sexes but length of stay was longer for females. Download FigureDownload PowerPoint Footnotes Oral Contributions B402 Sunday, April 7, 2024, 10:21 a.m.-10:31 a.m. Session Title: Highlighted Original Research: Ischemic Heart Disease and the Year in Review Abstract Category: 22. Ischemic Heart Disease: Clinical Science Presentation Number: 906-08",

author = "Lori Tam and Sahar Naderi and Wood, {Malissa J.} and Gerald Chi and Gornik, {Heather L.} and Wells, {Bryan J.} and Daniella Kadian-Dodov and Anna Grodzinsky and Angela Taylor and Hess, {Connie Ng} and Jennifer Lewey and Stanislav Henkin and Orford, {James Langley} and Kathryn Lindley and Wells, {Gretchen L.} and Rina Mauricio and Gibson, {C. Miachel} and Katherine Leon and Kim, {Soo Hyun}",

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T1 - Sex differences in Spontaneous Coronary Artery Dissection: A Report of the iSCAD Registry

AU - Tam, Lori

AU - Naderi, Sahar

AU - Wood, Malissa J.

AU - Chi, Gerald

AU - Gornik, Heather L.

AU - Wells, Bryan J.

AU - Kadian-Dodov, Daniella

AU - Grodzinsky, Anna

AU - Taylor, Angela

AU - Hess, Connie Ng

AU - Lewey, Jennifer

AU - Henkin, Stanislav

AU - Orford, James Langley

AU - Lindley, Kathryn

AU - Wells, Gretchen L.

AU - Mauricio, Rina

AU - Gibson, C. Miachel

AU - Leon, Katherine

AU - Kim, Soo Hyun

PY - 2024/4/1

Y1 - 2024/4/1

N2 - Background Spontaneous coronary artery dissection (SCAD) is a cause of myocardial infarction which most frequently affects perimenopausal women. To date, there is limited data regarding the characteristics of men who develop SCAD. Methods Detailed information regarding demographics, presenting characteristics, precipitating factors, and outcomes in males and females were obtained from the prospective, multicenter iSCAD Registry. Results Of 1,252 patients who experienced SCAD enrolled in the iSCAD Registry from 1/2019-9/2023, 80 (6.4%) were males. Mean age did not differ between sexes (females=49.7±10.4, males=50.2±10.3, p=0.792). Females more often reported emotional stress preceding SCAD. Males more often reported physical stress, both isometric and aerobic exertion. There were sex differences in symptoms, with females reporting a higher prevalence of non-chest discomfort, shortness of breath, and nausea/vomiting. Males had lower rates of autoimmune conditions, systemic inflammatory disorder, fibromuscular dysplasia, and migraine. Although in-hospital outcomes did not differ, length of stay was 6.1±19.0 days for females vs 3.8±2.4 days for males (p=0.003). Conclusion In a large US SCAD population, females more often reported emotional stress preceding SCAD while males reported physical exertion as a trigger. Females were more likely to present with non-chest discomfort symptoms. In-hospital outcomes were similar between sexes but length of stay was longer for females. Download FigureDownload PowerPoint Footnotes Oral Contributions B402 Sunday, April 7, 2024, 10:21 a.m.-10:31 a.m. Session Title: Highlighted Original Research: Ischemic Heart Disease and the Year in Review Abstract Category: 22. Ischemic Heart Disease: Clinical Science Presentation Number: 906-08

AB - Background Spontaneous coronary artery dissection (SCAD) is a cause of myocardial infarction which most frequently affects perimenopausal women. To date, there is limited data regarding the characteristics of men who develop SCAD. Methods Detailed information regarding demographics, presenting characteristics, precipitating factors, and outcomes in males and females were obtained from the prospective, multicenter iSCAD Registry. Results Of 1,252 patients who experienced SCAD enrolled in the iSCAD Registry from 1/2019-9/2023, 80 (6.4%) were males. Mean age did not differ between sexes (females=49.7±10.4, males=50.2±10.3, p=0.792). Females more often reported emotional stress preceding SCAD. Males more often reported physical stress, both isometric and aerobic exertion. There were sex differences in symptoms, with females reporting a higher prevalence of non-chest discomfort, shortness of breath, and nausea/vomiting. Males had lower rates of autoimmune conditions, systemic inflammatory disorder, fibromuscular dysplasia, and migraine. Although in-hospital outcomes did not differ, length of stay was 6.1±19.0 days for females vs 3.8±2.4 days for males (p=0.003). Conclusion In a large US SCAD population, females more often reported emotional stress preceding SCAD while males reported physical exertion as a trigger. Females were more likely to present with non-chest discomfort symptoms. In-hospital outcomes were similar between sexes but length of stay was longer for females. Download FigureDownload PowerPoint Footnotes Oral Contributions B402 Sunday, April 7, 2024, 10:21 a.m.-10:31 a.m. Session Title: Highlighted Original Research: Ischemic Heart Disease and the Year in Review Abstract Category: 22. Ischemic Heart Disease: Clinical Science Presentation Number: 906-08

U2 - 10.1016/S0735-1097(24)03140-1

DO - 10.1016/S0735-1097(24)03140-1

M3 - Other contribution

T3 - Articles, Abstracts, and Reports

ER -