580 Percutaneous coronary intervention or medical therapy as initial management strategy of patients with spontaneous coronary artery dissections: insight from the multicentre, international dissezioni spontanee coronariche (disco) registry

Autor: Stefano Benenati, Federico Giacobbe, Antonio Zingarelli, Truffa Giachet Alessandra, Primiano Lombardi, Giuseppe Musumeci, Sebastian Cinconze, Umberto Barbero, Mario Iannaccone, Giuseppe Patti, Antonio Rognoni, Marco Menunni, Angelo Di Leo, Vincenzo Infantino, Alfonso Gambino, Fabrizio D’Ascenzo, Francesco Bruno, Marco Pavani, Andrea Gagnor, Fabrizio Ugo, Chiara Cavallino, Gianluca Calogero Campo, Luca Bettari, Francesco Cassano, Matteo Perfetti, Massimiliano Scappaticci, Dario Buccheri, Elisabetta Bordoni, Chiara Bernelli, Alberto Boi, Ricardo Mori, Fernando Macaya, Javier Escaned, Enrico Cerrato, Italo Porto
Rok vydání: 2021
Předmět:
Zdroj: European Heart Journal Supplements. 23
ISSN: 1554-2815
1520-765X
Popis: Aims Whether patients with spontaneous coronary artery dissection (SCAD) should undergo an initial conservative management or immediate revascularization through percutaneous coronary intervention (PCI) remains debated. To investigate the frequency and predictors of choosing a strategy of immediate PCI for SCAD, and to compare the clinical outcomes of immediate PCI patients with those undergoing an initial strategy of medical management. Methods and results 369 patients enrolled in the multicentre international DIssezioni Spontanee COronariche (DISCO) registry between January 2009 and December 2020 were included. The primary endpoint was major adverse cardiovascular events (MACE), a composite of cardiac death, non-fatal myocardial infarction (MI) and any PCI. 240 (65%) patients underwent initial medical management, whereas 129 (35%) had immediate PCI. PCI patients presented more frequently with ST segment-elevation myocardial infarction (STEMI) (68.2% vs. 35%, P Conclusions The choice between an immediate medical or PCI management of SCAD is mostly driven by clinical presentation and procedural aspects. In the DISCO cohort, the primary treatment approach was not associated with the risk of short-to-midterm adverse events.
Databáze: OpenAIRE
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