Invasive and conservative treatment of spontaneous coronary artery dissection: a meta-analysis
T. O. Brodovskaja,
S. Saeed,
E. G. Babykina,
S. V. Potockij,
M. M. Tkachuk,
M. S. Ismailova,
I. F. Grishina,
T. F. Peretolchina,
T. V. Borodulina https://doi.org/10.52420/2071-5943-2022-21-5-102-115
Abstract
Background. This study aims to compare clinical outcomes of SCAD patients initially managed with medical therapy (conservative approach) versus intervention strategy. Materials and methods. We identified relevant studies by performing a systematic search in the PubMed, Google Scholar, Web of Science databases available from 1994 until 2021. The search was conducted using PICO tool (Patient, Intervention, Comparison, Outcome). Results and Discussion. 25 studies involving 2577 patients with SCAD were included. Mean age of patients was 49,2 years, 1985 (77,0 %) were female. The primary conservative strategy performed in 1593 (61,8 %) cases. Mean follow-up duration was 28,5 months. The conservative therapy showed benefit when assessing the overall mortality (OR 0,48; CI 0,27–0,86, p = 0,01) and revascularization frequency (OR 0,43; 95 % CI 0,22–0,81, p = 0.01). Statistically significant differences in myocardial infarction (OR 1,05; 95 % CI 0,66–1,66, p = 0,85) or recurrent SCAD (OR 1,1; 95 % CI 0,7–1,72, p = 0,69) were not revealed. Conclusion. The primary conservative strategy of SCAD therapy is associated with lower overall mortality and further revascularization, but not MI and recurrent SCAD. Further research is needed to clarify the best therapeutic approach in patients with SCAD.
About the Authors
T. O. Brodovskaja
Ural State Medical University
Russian Federation
Russian Federation
Tat'jana O. Brodovskaja, Doctor of Science (Medicine)
Ekaterinburg
S. Saeed
Haukeland University Hospital
Norway
Norway
Saeed Sahraj, Doctor of Science (Medicine), PhD
Bergen
E. G. Babykina
Universitede Lille
France
France
Evgenija G. Babykina, mathematics professor, PhD
Lille
S. V. Potockij
P.D. Borodin Central City Hospital
Russian Federation
Russian Federation
Stanislav V. Potockij, Physician
Verkhnyaya Pyshma, Sverdlovsk Region
M. M. Tkachuk
Ural State Medical University
Russian Federation
Russian Federation
Marija M. Tkachuk, Student
Ekaterinburg
M. S. Ismailova
Ural State Medical University
Russian Federation
Russian Federation
Medine S. Ismailova, Student
Ekaterinburg
I. F. Grishina
Ural State Medical University
Russian Federation
Russian Federation
Irina F. Grishina, Doctor of Science (Medicine), Professor
Ekaterinburg
T. F. Peretolchina
Ural State Medical University
Russian Federation
Russian Federation
Tat'jana F. Peretolchina, Doctor of Science (Medicine), Professor
Ekaterinburg
T. V. Borodulina
Ural State Medical University
Russian Federation
Russian Federation
Tat'jana V. Borodulina, Doctor of Science (Medicine), Associate Professor
Ekaterinburg
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For citations:
Brodovskaja TO, Saeed S, Babykina EG, Potockij SV, Tkachuk MM, Ismailova MS, Grishina IF, Peretolchina TF, Borodulina TV. Invasive and conservative treatment of spontaneous coronary artery dissection: a meta-analysis. Ural Medical Journal. 2022;21(5):102-115. (In Russ.) https://doi.org/10.52420/2071-5943-2022-21-5-102-115
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