Canadian Spontaneous Coronary Artery Dissection Study

Nickname: SCAD Study

Principal Investigators

Dr. Jacqueline Saw, Clinical Associate Professor, UBC Division of Cardiology, Vancouver General Hospital

Funding

Canadian Institutes of Health Research (2014 – 2019)

Participating Centres

To be confirmed

Website

http://scad.ubc.ca/

Background

Spontaneous coronary artery dissection (SCAD) occurs when the inner layers of a coronary artery separate, often due to a tear, causing a blockage in the vessel and reducing blood flow to the heart.  It is a critical condition that can result in chest pain, heart attack and even death.

Little is known about non-atherosclerotic (NA) SCAD with regards to its disease progression, risk and causal factors. It is especially problematic because NA-SCAD appears to affect mostly young, otherwise healthy females. Published data are limited and inconsistent regarding outcomes and predisposing factors, largely due to limited data and disparity in predisposing conditions. Thus, this project aims to be the largest, most comprehensive study of SCAD to date.

Objectives

  1. To evaluate the overall natural history of NA-SCAD, in particular the various conditions which increase the likelihood of developing SCAD and how it affects in-hospital and long term risks of cardiac events.
  2. To evaluate the effects of various initial treatment options for SCAD in relation to both in-hospital and long term patient recovery.

Methodology

This 3-year national prospective cohort study will follow 750 Canadian women (aged <65 years) who have suffered a heart attack as a result of NA-SCAD. These patients will be recruited from 17 sites in 6 provinces.  Initial treatment (surgery, stenting or medication) will be evaluated to see how it affects in-hospital recovery and long-term health outcomes.  Risk factors and potential underlying causes will also be investigated through detailed questionnaires, blood work and laboratory tests.

Significance

The Canadian SCAD study will be largest, most comprehensive study on SCAD to date, and have significant impacts on the diagnosis, investigation, and management of NA-SCAD. Further, the results will promote greater awareness and understanding of the condition amongst health care professionals, patients and the general public.