Clinical ResearchNonatherosclerotic Coronary Artery Disease in Young Women
Section snippets
Methods
We retrospectively reviewed all women aged 50 years and younger who underwent coronary angiography at Vancouver General Hospital (VGH) from December 1, 2009 to November 30, 2011. The baseline characteristics and medication use were recorded from the VGH cardiac catheterization database and clinical records. Patients with ACS or stable symptoms were included. The angiograms were reviewed meticulously by 2 experienced interventional cardiologists (J.S., E.A., or D.R.), who had each performed more
Results
Of 7605 coronary angiograms performed at VGH during this 2-year period, 177 were performed in women aged 50 years and younger. The baseline characteristics are described in Table 1. The mean age was 45.4 ± 4.9 (range, 31-50) years, and average body mass index was 27.9. Coronary angiograms were done in 27.1% of these women because of ischemia on stress testing. Overall, 76 of 177 (42.9%) presented with ACS, and 66 of these (37.3%) had increased troponin levels.
The angiographic findings are
Discussion
We reviewed the coronary angiograms of all young women aged 50 years and younger who underwent angiography over a 2-year period at our institution. We found that NACAD was an important diagnosis observed in 13% of these patients, especially those who presented with troponin-positive ACS, of whom NACAD accounted for approximately 30% of the diagnoses. SCAD was the most frequently observed form of NACAD, accounting for approximately 70% of NACAD. In fact, among patients who presented with
Conclusions
Among young women aged 50 years and younger undergoing coronary angiography, NACAD is not rare and is observed in 13% of these patients, of which approximately 70% were due to SCAD. In particular, SCAD accounts for almost a quarter of young women presenting with MI. These observations need to be confirmed in larger prospective studies, but do highlight the need to improve the diagnosis of SCAD on angiography.
Disclosures
The authors have no conflicts of interest to disclose.
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