Prevalence of pregnancy-related coronary disease

Although spontaneous coronary artery dissection is a known cause of myocardial infarction among women, there is currently little understanding of the condition in pregnancy.

In a study published in JAMA Cardiology, investigators used patient surveys as well as reproductive history and demographic, psychosocial, clinical and imaging data to examine the risk of pregnancy-associated spontaneous coronary artery dissection among more than 900 women with spontaneous coronary artery dissection who had at least one pregnancy.

The investigators found that nearly 100 of the participants experienced pregnancy-associated spontaneous coronary artery dissection. Compared with those who had non-pregnancy-associated spontaneous coronary artery dissection and individuals in the general population, the participants who had pregnancy-associated spontaneous coronary artery dissection had higher median ages at pregnancy; were more likely to have more than five pregnancies, preeclampsia and assisted reproductive technology use; were less likely to present with fibromuscular dysplasia; and had comparable rates of extracoronary abnormalities such as aneurysms and dissection. Further, the participants in the pregnancy-associated spontaneous coronary artery dissection group had a more severe phenotype, evident in the higher incidence of ST-segment elevation myocardial infarction, multivessel segment involvement and left ventricular ejection fraction below 40% as well as poorer one-year left ventricular ejection fraction recovery.

The findings highlighted the high risk faced by patients with pregnancy-associated spontaneous coronary artery dissection and the critical need for more effective management strategies.

Read more: JAMA Cardiology

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