Characteristics and Prognosis of Patients With Fibromuscular Dysplasia in a Population of Spontaneous Coronary Artery Dissections (from the French Registry of Spontaneous Coronary Artery Dissections “DISCO”)

• Published in: The American journal of cardiology Vol. 175; pp. 38 - 43
• Main Authors: Combaret, Nicolas, Liabot, Quentin, Deiri, Mays, Lhermusier, Thibault, Boiffard, Emmanuel, Filippi, Emmanuelle, Roule, Vincent, Georges, Jean-Louis, Manzo-Silberman, Stéphane, Fluttaz, Arnaud, Marliere, Stéphanie, Souteyrand, Géraud, Pereira, Bruno, Cassagnes, Lucie, Motreff, Pascal
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.07.2022; Elsevier Limited
• Subjects: Acute coronary syndromes; Birth control; Blood pressure; Coronary Angiography - methods; Coronary artery; Coronary Vessel Anomalies - diagnostic imaging; Coronary Vessel Anomalies - epidemiology; Coronary vessels; Coronary Vessels - pathology; Dissection; Dysplasia; Dyspnea; Fibromuscular Dysplasia - diagnostic imaging; Fibromuscular Dysplasia - epidemiology; Heart attacks; Heart rate; Humans; Hypertension; Hypotheses; Magnetic resonance imaging; Medical imaging; Medical prognosis; Patients; Phenotypes; Population; Post-menopause; Prognosis; Registries; Risk factors; Tomography; Ultrasonic imaging; Vascular Diseases - congenital; Vascular Diseases - epidemiology; Veins & arteries
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2022.04.007

Spontaneous coronary artery dissection (SCAD) and fibromuscular dysplasia (FMD) are pathologies that appear to be closely related. This study compares the characteristics of the FMD population to the non-FMD population in a SCAD cohort. It thus assesses the involvement of the FMD phenotype in a SCAD population. From the data of the French DISCO registry, we included patients with a diagnosis of SCAD and in whom a search for FMD was performed. We collected the following characteristics of this population: the clinical and angiographic presentation, the data concerning the management, and the events occurring during the follow-up. In the 373 SCADs confirmed in the DISCO registry, we obtained imaging data for 340 of them. FMD was found in 45% of cases. The mean age was higher in the FMD group, 53.2 ± 8.8 years, versus 50.1 ± 11 years in the non-FMD group. High blood pressure and postmenopausal status were significantly higher in the FMD group. Clinical presentation, angiographic data, and management were comparable. The major adverse cardiac event rate and recurrence rate were not different between the 2 groups after 1 year of follow-up. In conclusion, we confirmed a 45% prevalence of FMD in the SCAD population. The median age was higher in the FMD group, suggesting that FMD may develop over time. The rate of major adverse cardiac events and recurrence were similar in the FMD group versus the non-FMD group after 1 year of follow-up.