Abstract 18913: Spontaneous Coronary Artery Dissection in Women and Association With Hormonal Stressors
Notice bibliographique
Résumé
Background: Spontaneous coronary artery dissection (SCAD) is an infrequent but important cause of myocardial infarction (MI) in women. Chronic exposure to hormonal therapy, fluctuation in hormonal levels, and a history of multiple pregnancies had been postulated to predispose to SCAD. However, these were not well described in the literature. Methods: Women with SCAD who have consented and are prospectively followed in our Vancouver General Hospital SCAD registries are included in this study. Their background hormonal exposure, pregnancy, and gynaecological histories were extracted from questionnaires, clinical histories, and medical records. These were correlated to in-hospital and long-term outcomes. Results: We included 187 women with SCAD, with mean age 52.6 ± 8.7 years. The majority were Caucasian (83.4%) and 74.0% had fibromuscular dysplasia. All patients presented with MI. Mean number of pregnancy in this cohort was 2.5, with 45 (24.1%) and 25 (13.4%) having ≥4 and ≥5 pregnancies, respectively. Mean number of live births (parity) was 1.8, with 52 (27.8%) having ≥3 births, and 16 (8.6%) having ≥4 births. There were 3 post-partum SCAD (<1 year) and they were still breastfeeding. In terms of hormonal therapy, 28 (15.0%) were actively on hormonal therapy; 5 (2.7%) had prior fertility treatment, 51 (27.3%) had hormone replacement therapy (HRT), 76 (40.6%) had oral contraception, and 36 (19.3%) had gynaecological procedures. There were 107 (57.2%) post-menopausal women, and 23 (12.3%) were peri-menopausal at presentation. There was no death during acute SCAD admission, but 3 died at follow-up (mean 4.1 ± 3.9yrs), and 36 (19.3%) had recurrent SCAD. Patients actively on hormones had higher rate of recurrent SCAD (32.1% vs. 15.8%, p=0.039). There was a higher recurrent MI rate in premenopausal women during index admission (8.9% vs. 1.9%, p=0.037). There was no significant difference in in-hospital and follow-up events in women with past hormonal therapy, post-partum women, or those with parity ≥4 or gravida ≥5. Conclusion: Significant proportion of women with SCAD had exposure to hormonal therapy or had multiple pregnancies/births. Patients actively on hormonal therapy appeared to have higher recurrent SCAD events at follow-up.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».