What the study found: Women with pregnancy-associated spontaneous coronary artery dissection (SCAD, a tear in a coronary artery) had a different profile from women with non-pregnancy-associated SCAD and tended to have more severe SCAD events. The authors report lower rates of fibromuscular dysplasia, higher rates of assisted reproductive technology use, more very high numbers of pregnancies, more preeclampsia, and less recovery of left ventricular ejection fraction (the heart’s pumping measure) by 1 year.
Why the authors say this matters: The authors conclude that women with pregnancy-associated SCAD represent a higher-risk group. They suggest the findings add reproductive-health detail to a condition that has had limited data and may help characterize this group in a contemporary, multicenter registry.
What the researchers tested: The study used data from the iSCAD Registry, a large multicenter cohort, and compared women with pregnancy-associated SCAD to women with non-pregnancy-associated SCAD. The researchers collected survey-based clinical and reproductive histories and corroborated them with investigator-extracted clinical and imaging data, then compared groups using 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 pregnancy-associated SCAD. Compared with the non-pregnancy-associated group, the pregnancy-associated group had lower fibromuscular dysplasia prevalence, similar extracoronary abnormalities, higher reported assisted reproductive technology use, more multigravida with more than five gestations, and more preeclampsia. They also had more STEMI (ST-segment elevation myocardial infarction, a type of heart attack), more multivessel segment involvement, more left ventricular ejection fraction below 40%, and less left ventricular ejection fraction recovery at 1 year; most women in both groups were primarily medically managed.
What to keep in mind: The abstract does not describe all possible limitations of the registry or survey data. It does note that the comparison was made in women with a history of at least one pregnancy and that some results were based on available subgroup data, which may vary across measures.
Key points
- Pregnancy-associated SCAD was linked with a more severe coronary event pattern than non-pregnancy-associated SCAD.
- Women with pregnancy-associated SCAD had lower fibromuscular dysplasia rates but similar extracoronary abnormalities.
- Assisted reproductive technology use, more than five gestations, and preeclampsia were reported more often in the pregnancy-associated group.
- Pregnancy-associated SCAD showed higher STEMI rates, more multivessel involvement, and lower left ventricular ejection fraction recovery at 1 year.
- 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:
- University of Pittsburgh Medical Center, Saint Luke's Health System, Saint Luke's Hospital, Atrium Medical Cente, Kaiser Permanente, Beth Israel Deaconess Medical Center, Icahn School of Medicine at Mount Sinai, University Hospitals of Cleveland, Emory University, University of Virginia Medical Center, Providence College, Hope Heart Institute, University of Colorado Denver, University of Pennsylvania, Dartmouth–Hitchcock Medical Center, Intermountain Medical Center, University of Kentucky, The University of Texas Southwestern Medical Center, Vanderbilt University Medical Center, Society of General Internal Medicine, University of California, Los Angeles, Brigham and Women's Hospital
- Publication date:
- 2026-03-29
- OpenAlex record:
- View
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