To examine the incidence and range of FMD and other extra coronary arterial anomalies in people with SCAD compared with healthy controls between January 1, 2015, and December 31, 2019, 173 persons with angiographically confirmed SCAD were included in the study. Magnetic resonance angiography (MRA) images the extra coronary arterial beds. Healthy individuals were chosen to act as controls for MRA findings. Patients were invited from the UK’s national SCAD registry, maintained by referrals from the primary care doctor or through an Internet portal received by patients. Participants visited the SCAD referral center in their area for assessment and MRA. Healthy adults and individuals with SCAD were imaged using a full-body MRA. Both groups underwent head-to-pelvis MR imaging (median time between SCAD event and MR, 1 [IQR, 1-3] year). The International FMD Consensus was followed in diagnosing FMD, arterial dissections, and aneurysms. The presence of an S curve (qualitative) and the number of turns with a tortuosity index of 45% or more (quantitative) were examined.SCAD affected 173 persons, of which 167 were women (96.5%); the average age at diagnosis was 44.5 years (7.9). The incidence of FMD was 31.8% (55 individuals), with 16 people (29.1% of those with FMD) having involvement in multiple vascular beds. Furthermore, 13 patients (7.5%) had extra coronary aneurysms, and 3 individuals (1.7%) had dissections. In the research, the incidence and severity of arterial tortuosity were similar in cases and controls. The detection of clinically significant remote arteriopathies was comparable in patients imaged with computed tomographic angiography and MRA. Over a 5-year follow-up, there were 2 noncardiovascular-related deaths and 35 secondary myocardial infarctions, with no primary extravascular vascular events. In the case series, the event rate was low for severe multivessel FMD, aneurysms, and dissections. The outcomes of the research suggested that, although brain-to-pelvis imaging was capable of detecting remote arteriopathies that might have needed follow-up, extra coronary vascular events appeared to be uncommon.
Link:jamanetwork.com/journals/jamacardiology/fullarticle/2786555
