What the study found
Women with pregnancy-associated spontaneous coronary artery dissection, or P-SCAD, had several reproductive and clinical differences compared with women whose SCAD was not associated with pregnancy. The study found higher use of assisted reproductive technology, more preeclampsia, and a more severe heart event pattern in the P-SCAD group.
Why the authors say this matters
The authors conclude that women with P-SCAD represent a higher-risk phenotype and that these findings add reproductive health information to a condition where such data have been limited. They also note that the results are relevant because the cohort had high rates of vascular imaging and showed differences in heart recovery after the event.
What the researchers tested
The researchers used data from the iSCAD Registry, a large multicenter registry, and compared women with P-SCAD to women with non-pregnancy-associated SCAD, or NP-SCAD, from 2019 to 2024. They analyzed survey-based clinical and reproductive history, along with investigator-confirmed clinical and imaging data, and compared groups using Kruskal-Wallis and chi-square tests.
What worked and what didn't
Among 907 women with SCAD and at least one pregnancy, 98 had P-SCAD. Compared with NP-SCAD, the P-SCAD group had lower fibromuscular dysplasia, similar rates of extracoronary abnormalities, more assisted reproductive technology use, more multigravida with more than five gestations, and more preeclampsia. They also had more severe SCAD features, including more STEMI, more multivessel segment involvement, lower left ventricular ejection fraction, and less recovery of left ventricular ejection fraction by one year; most women in both groups were managed medically.
What to keep in mind
This summary is based on a registry cohort and comparisons with both NP-SCAD and general U.S. reproductive-aged population rates. The abstract does not describe all potential limitations, and some comparisons involved smaller numbers within subgroups, such as the left ventricular ejection fraction analyses.
Key points
- 98 of 907 women with prior pregnancies had pregnancy-associated SCAD.
- P-SCAD was linked with higher use of assisted reproductive technology and more preeclampsia.
- Women with P-SCAD had lower rates of fibromuscular dysplasia than women with NP-SCAD.
- P-SCAD was associated with more severe heart-event features, including STEMI and multivessel involvement.
- Left ventricular ejection fraction recovery by 1 year was less in the P-SCAD group.
Disclosure
- Research title:
- Pregnancy-associated SCAD showed a higher-risk clinical pattern
- Authors:
- Agnes Koczo, Anna Grodzinsky, Esther S.H. Kim, Sahar Naderi, Gerald Chi, Daniella Kadian-Dodov, Heather L. Gornik, Bryan Wells, Angela Taylor, Lori Tam, Connie Hess, Jennifer Lewey, Stanislav Henkin, James L. Orford, Gretchen Wells, Rina Mauricio, Kathryn J. Lindley, C. Michael Gibson, Katherine K. Leon, Malissa J. Wood, Jennifer A. Sumner, Nandita S. Scott
- Institutions:
- Atrium Medical Cente, Beth Israel Deaconess Medical Center, Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Dartmouth–Hitchcock Medical Center, Emory University, Hope Heart Institute, Icahn School of Medicine at Mount Sinai, Intermountain Medical Center, Kaiser Permanente, Providence College, Saint Luke's Health System, Saint Luke's Hospital, Society of General Internal Medicine, Society of General Internal Medicine, The University of Texas Southwestern Medical Center, University Hospitals of Cleveland, University of California, Los Angeles, University of Colorado Denver, University of Kentucky, University of Pennsylvania, University of Pittsburgh Medical Center, University of Virginia Medical Center, Vanderbilt University Medical Center
- Publication date:
- 2026-03-29
- OpenAlex record:
- View
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