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High prevalence of silent aneurysms and fibromuscular dysplasia in spontaneous coronary artery survivors: analysis of the SCAD-POL Registry

Year: 2026

Type: article

Abstract: INTRODUCTION: Extracoronary vascular abnormalities (EVAs) have been found in patients with spontaneous coronary artery dissection (SCAD), suggesting that SCAD may reflect systemic vascular disease. OBJECTIVE: The aim of this study was to assess the prevalence and characteristics of EVAs in SCAD survivors. PATIENTS AND METHODS: A total of 109 consecutive patients with a history of SCAD underwent head‑to‑ pelvis computed tomography angiography for EVA screening. EVAs were defined as the presence of fibromuscular dysplasia (FMD), aneurysm, or cervical dissections. RESULTS: EVAs were identified in 47.7% of the cohort. The prevalence of FMD was 32.1%, aneurysms were observed in 23.2% of the patients, and dissections of cervical arteries in 5.5%, while 9.3% of the patients presented with both FMD and aneurysms. FMD predominantly affected the renal (20.3%) and cervical (15.6%) arteries, while aneurysms were most commonly detected in the renal and splenic arteries (7.3% each). Multisite FMD was present in 8.3% of the patients. Aneurysms in more than 1 vascular bed were found in 4.6% of the cases. Cervical FMD was associated with migraine headaches in 58.8% of the patients and was clinically silent in 41.2%. All aneurysms were silent, however, 3 patients (12%) with intracerebral aneurysms required intravascular treatment due to a risk of rupture. In FMD patients, higher prevalence of type 2a SCAD (65.7% vs 43.1%; P = 0.03) and pregnancy‑ associated SCAD (17.6% vs 4.2%; P = 0.03) was observed. The patients with type 2a SCAD had a 2.5‑ fold higher likelihood of having FMD (odds ratio, 2.53; 95% CI, 1.09-5.87; P = 0.03). CONCLUSIONS: This study showed a significant prevalence of EVAs in SCAD survivors, with silent aneurysms being more common than previously reported.

Source: Polskie Archiwum Medycyny Wewnętrznej

DOI: 10.20452/pamw.17254

Authors: Natalia Wiligórska, Joanna Zalewska, Michał Nowicki, Ilona Michałowska, Sławomir Gołębiewski, Izabela Wojtkowska, Andrzej Sumiński, Ilona Kowalik, Gabriela Soćko, Andrzej Januszewicz, Adam Witkowski, Jacek Kądziela

Institutions: Institute of Cardiology, Medical University of Warsaw, Wojskowy Instytut Medyczny

Language: English

Topic: Cardiovascular Issues in Pregnancy

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7138041515

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