Background: Extra-coronary involvement is identified in more than 50% of patients presenting with SCAD, mainly as fibromuscular dysplasia (FMD) pattern. This association might suggest that they share at least partially some pathomechanisms. However, no recommendations on FMD screening in SCAD patients exist to date in international consensus documents, and this is therefore left at clinician discretion.
Aim: We sought to determine the rate of FMD screening in historical cohort of patients with SCAD at our institution.
Methods: Observational retrospective study of all consecutive SCAD patients admitted to catheterization laboratory.
Results: From January 2015 to June 2021, 41 patients received a SCAD diagnosis and represented our study cohort. Mean age was 55 ± 11 years with a high prevalence of female gender (34 patients, 83%). Traditional risk factors showed a marked prevalence especially regarding smoke habits (12 patient, 30%) and dyslipidaemia (21 patients, 51%). Left anterior descending artery was the vessel more frequently involved (49%) followed by circumflex artery (41%) and right coronary artery (10%). SCAD was more frequently classified as type II (68%) followed by type IV (17%), type I (10%) and type III (5%) according to Saw classification. Screening for FMD was performed in 6 patients (12%) among the most recent SCAD diagnoses; of these 1 patients received a diagnosis of FMD, with involvement of carotid and mesenteric arteries. Table.
Conclusion: In our single centre experience, screening for FMD was historically performed in a minority of patients with a perceived trend for a systematic screening in more recent years.
