Twenty-five-year trends in incidence, angiographic appearance, and management of spontaneous coronary artery dissection

Spontaneous coronary artery dissection (SCAD) has been described as an infrequent cause of acute coronary syndrome (ACS). Knowledge about the disease is still limited and SCAD might still be underdiagnosed. Trends in incidence, presentation, angiographic appearance, management, and outcomes of SCAD over 25 years were analyzed. Patients with SCAD between 1997 and 2021 at the University Hospital Zurich, Switzerland, were included. Incidences were assessed as total numbers and proportions of ACS cases. Clinical data were collected from medical records and angiographic findings were reviewed. Major adverse cardiac events (MACE) were defined as the composite of all-cause death, cardiac arrest, SCAD recurrence or progression, other myocardial infarction, and stroke. One hundred fifty-six SCAD cases were included in this study. The incidence increased significantly in total (p