Increasing Incidence of Spontaneous Coronary Artery Dissection (SCAD) in Christchurch

Abstract

Background: Improvements in the understanding of Spontaneous Coronary Artery Dissection (SCAD) have allowed greater recognition of this condition in recent years. However, the true incidence remains unknown. We sought to examine whether the incidence of SCAD in Christchurch has increased over the last five years. Method: All patients with angiographically confirmed SCAD since January 2014 were included in this study. Numbers of SCAD were compared against the total number of patients with acute coronary syndrome (ACS) who presented to Christchurch Public Hospital and underwent coronary angiogram, identified by the ANZACS-QI database. Results: A total of 81 patients (89% female, median age 54) were diagnosed with SCAD over 5 years. One-sided p-value derived using Cochrane-Armitage Trend test is <0.0001 for all SCAD, <0.0001 for females and <0.0006 for females <60 years, suggesting a statistically clear upward trend over the 5 years. SCAD diagnoses per year (and as proportion of ACS)Tabled 120142015201620172018All SCAD4 (0.3%)14 (1.0%)10 (0.7%)22 (1.6%)31 (2.2%)Female4 (1.0%)12 (2.4%)10 (2.0%)19 (4.1%)27 (5.6%)Female <604 (5.6%)4 (4.3%)5 (4.7%)12 (11.8%)18 (15.9%) Open table in a new tab Conclusion: The incidence of SCAD in Christchurch appears to be increasing. The true incidence of SCAD remains unknown although it may represent more than 2% of all presentations with ACS and significantly more in females. Further research should aim at improving diagnosis and identifying the cause of this fascinating condition.