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Background <p>Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) remains an incompletely characterized cause of acute coronary syndrome during pregnancy and postpartum period. We aimed to compare clinical presentation, comorbidities and outcomes of P-SCAD with non-pregnancy associated spontaneous coronary artery dissection (NP-SCAD).</p> Methods <p>We studied 83 women with prior SCAD and at least one pregnancy (aged 44.8 ± 9.7y at SCAD event, 36% with hypertension), including 11 P-SCAD and 72 NP-SCAD cases in SCAD-POL Registry. P-SCAD was defined as SCAD occurring during pregnancy or within 12&#xa0;months postpartum.</p> Results <p>P-SCAD occurred between 2 and 32&#xa0;weeks after delivery. Compared with NP-SCAD, women with P-SCAD were younger (33.1 ± 4.9 vs 46.4 ± 9.1y, <i>p</i> &lt; 0.001), had higher parity (3.6 ± 1.2 vs 2.5 ± 1.1 pregnancies, <i>p</i> &lt; 0.01) and more often reported ≥ 1 miscarriage (63.5% vs 27.8%, <i>p</i> &lt; 0.05). Pregnancies in the P-SCAD were more frequently complicated with hypertension (45.5% vs 6.9%, <i>p</i> &lt; 0.005) and pre-eclampsia (27.3% vs 1.4%, <i>p</i> &lt; 0.01). All P-SCAD patients had at least one caesarean section versus 35.8% in the NP-SCAD group (<i>p</i> &lt; 0.001). P-SCAD patients more often required coronary bypass grafting (18.2% vs 1.6%, <i>p</i> &lt; 0.05). Frequency of fibromuscular dysplasia was non-significantly higher in P-SCAD (45.5% vs 29.2%).</p> Conclusions <p>Pregnancies in women with P-SCAD were more often complicated by hypertension, pre-eclampsia and miscarriage than in NP-SCAD. P-SCAD events occurred mainly in the early postpartum period and more often required surgical revascularization. Given the small sample, these findings are exploratory and hypothesis-generating.</p> Graphical abstract <p></p>

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Pregnancy-related spontaneous coronary artery dissection: insights from the SCAD-POL registry and a literature review

  • 期刊论文

  • 发表日期：

    2026年2月9日

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  • Joanna Zalewska,
  • Wiktoria Niegowska,
  • Ilona Michałowska,
  • Maciej Gamski,
  • Aneta Gziut-Rudkowska,
  • Piotr Dobrowolski,
  • Rafał Wolny,
  • Przemysław Kosiński,
  • Jakub Kądziela,
  • Anna Aniszczuk-Hybiak,
  • Andrzej Januszewicz,
  • Adam Witkowski,
  • Jacek Kądziela

摘要

Background

Pregnancy-associated spontaneous coronary artery dissection (P-SCAD) remains an incompletely characterized cause of acute coronary syndrome during pregnancy and postpartum period. We aimed to compare clinical presentation, comorbidities and outcomes of P-SCAD with non-pregnancy associated spontaneous coronary artery dissection (NP-SCAD).

Methods

We studied 83 women with prior SCAD and at least one pregnancy (aged 44.8 ± 9.7y at SCAD event, 36% with hypertension), including 11 P-SCAD and 72 NP-SCAD cases in SCAD-POL Registry. P-SCAD was defined as SCAD occurring during pregnancy or within 12 months postpartum.

Results

P-SCAD occurred between 2 and 32 weeks after delivery. Compared with NP-SCAD, women with P-SCAD were younger (33.1 ± 4.9 vs 46.4 ± 9.1y, p < 0.001), had higher parity (3.6 ± 1.2 vs 2.5 ± 1.1 pregnancies, p < 0.01) and more often reported ≥ 1 miscarriage (63.5% vs 27.8%, p < 0.05). Pregnancies in the P-SCAD were more frequently complicated with hypertension (45.5% vs 6.9%, p < 0.005) and pre-eclampsia (27.3% vs 1.4%, p < 0.01). All P-SCAD patients had at least one caesarean section versus 35.8% in the NP-SCAD group (p < 0.001). P-SCAD patients more often required coronary bypass grafting (18.2% vs 1.6%, p < 0.05). Frequency of fibromuscular dysplasia was non-significantly higher in P-SCAD (45.5% vs 29.2%).

Conclusions

Pregnancies in women with P-SCAD were more often complicated by hypertension, pre-eclampsia and miscarriage than in NP-SCAD. P-SCAD events occurred mainly in the early postpartum period and more often required surgical revascularization. Given the small sample, these findings are exploratory and hypothesis-generating.

Graphical abstract