Abstract 13419: Racial Differences in Patients With Spontaneous Coronary Artery Dissection: A Report of the ISCAD Registry

Abstract

Introduction: Spontaneous coronary artery dissection (SCAD) is a nonatherosclerotic cause of myocardial infarction. The demographics and clinical differences based on race in patients with SCAD are not well understood. Methods: Demographics and clinical variables were obtained from the prospective, multicenter iSCAD Registry. Characteristics of study participants (including demographics, past medical history, timeline, imaging studies, follow-up visits, SCAD presentation, and treatment) were compared between white and non-white patients. Race and ethnicity was self-reported by a patient questionnaire. Results: A total of 505 patients were included in the analysis. Among them, 427 (84.6%) were characterized as white and 78 (15.4%) were characterized as non-white. White patients were 49.5 years and non-white patients were 46.8 years at the time of the initial SCAD presentation (p=0.0435). White patients were more likely to be married (77% vs 51%, p<0.0001) and were more likely to have a college degree (42 vs 28%, p<0.0001). White patients were more likely to present to the hospital in less than 24 hours (85% vs 75%, p=0.07) and have an angiogram in less than 24 hours (78% vs 58%, p=0.004). White patients were more likely to present with STEMI (30% vs 11%, p=0.004) and were more likely to receive revascularization (25% vs 11%, p=0.0147). A multivariable analysis explored the variables associated with angiography greater than 24 hours. STEMI vs NSTEMI [OR 0.090 (0.035 to 0.231), p<0.0001] and white vs non-white [OR 0.376 (0.188 to 0.755), p=0.0059] remained significant. White patients were more likely to have fibromuscular dysplasia (FMD), (43% vs 30%, p=0.0336). There was no significant difference in the number of non-coronary vascular imaging studies between the two groups. Conclusions: The number of non-white patients enrolled in the iSCAD registry is low. White patients with SCAD were more likely to present with STEMI and were more likely to have a diagnosis of FMD. Further research is needed to study associations between race and differences in presentation, comorbidities, and treatment in patients with SCAD.