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Pregnancy-associated SCAD showed a higher-risk clinical pattern

A pregnant woman lies on a medical examination bed in a hospital room, wearing a green drape, while holding a handheld ultrasound probe or medical device near her abdomen, with cardiac monitoring equipment visible on the wall behind her.
Research area:MedicineCardiology and Cardiovascular MedicineCardiovascular Issues in Pregnancy

What the study found

Women with pregnancy-associated spontaneous coronary artery dissection, or P-SCAD, had a distinct pattern compared with women whose SCAD was not pregnancy-associated. They more often had a history of assisted reproductive technology, more than five pregnancies, and preeclampsia, and they showed a more severe SCAD event profile with less recovery of left ventricular ejection fraction, or the heart's pumping measure.

Why the authors say this matters

The authors conclude that women with P-SCAD remain a higher-risk phenotype in this contemporary cohort and were mostly managed conservatively. The findings indicate that detailed reproductive history and vascular imaging may help describe P-SCAD more fully, including how it differs from non-pregnancy-associated SCAD.

What the researchers tested

The study used the multicenter iSCAD Registry to compare women with P-SCAD and women with non-pregnancy-associated SCAD from 2019 to 2024. The researchers collected survey-based clinical and reproductive histories and corroborated them with investigator-reviewed clinical and imaging data, then compared groups with Kruskal-Wallis tests for continuous variables and chi-square tests for categorical variables.

What worked and what didn't

Among 907 women with SCAD and at least one prior pregnancy, 98 had P-SCAD. Compared with women with non-pregnancy-associated SCAD, those with P-SCAD had lower fibromuscular dysplasia rates, similar extracoronary abnormalities, and higher rates of assisted reproductive technology use, multigravida with more than five gestations, and preeclampsia. They also had higher rates of ST-elevation myocardial infarction, multivessel involvement, and left ventricular ejection fraction below 40%, and they had less recovery of left ventricular ejection fraction by 1 year.

What to keep in mind

This summary is based on a registry cohort and patient-reported reproductive history, even though the information was corroborated with clinical and imaging data. The abstract does not describe all potential limitations, and it does not provide details on long-term outcomes beyond 1-year left ventricular ejection fraction recovery.

Key points

  • P-SCAD accounted for 98 of 907 women with SCAD and at least one prior pregnancy.
  • Women with P-SCAD had more assisted reproductive technology use, more than five gestations, and preeclampsia than women with non-pregnancy-associated SCAD.
  • P-SCAD was linked to a more severe event pattern, including more ST-elevation myocardial infarction and multivessel involvement.
  • Fibromuscular dysplasia was less common in P-SCAD, while extracoronary abnormalities were similar.
  • Left ventricular ejection fraction recovered less by 1 year in the P-SCAD group.
  • Most women in both groups were primarily medically managed.

Disclosure

Research title:
Pregnancy-associated SCAD showed a higher-risk clinical pattern
Authors:
Agnes Koczo, Anna Grodzinsky, Esther S.H. Kim, Sahar Naderi, Gerald Chi, Daniella Kadian-Dodov, Heather L. Gornik, Bryan Wells, Angela Taylor, Lori Tam, Connie Hess, Jennifer Lewey, Stanislav Henkin, James L. Orford, Gretchen Wells, Rina Mauricio, Kathryn J. Lindley, C. Michael Gibson, Katherine K. Leon, Malissa J. Wood, Jennifer A. Sumner, Nandita S. Scott
Institutions:
Atrium Medical Cente, Beth Israel Deaconess Medical Center, Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Dartmouth–Hitchcock Medical Center, Emory University, Hope Heart Institute, Icahn School of Medicine at Mount Sinai, Intermountain Medical Center, Kaiser Permanente, Providence College, Saint Luke's Health System, Saint Luke's Hospital, Society of General Internal Medicine, Society of General Internal Medicine, The University of Texas Southwestern Medical Center, University Hospitals of Cleveland, University of California, Los Angeles, University of Colorado Denver, University of Kentucky, University of Pennsylvania, University of Pittsburgh Medical Center, University of Virginia Medical Center, Vanderbilt University Medical Center
Publication date:
2026-03-29
DOI:
10.1001/jamacardio.2026.1009
OpenAlex record:
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AI provenance: This post was generated by gpt-5.4-mini (OpenAI). The original authors did not write or review this post.

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