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Medications And Their Potential To Cause Increase 'Artery Dissection'
List of Drugs that may cause 'Artery dissection'Advertisement
Updated on November 16, 2023 This section presents medications that are known to potentially lead to 'Artery dissection' as a side effect." It's important to note that mild side effects are quite common with medications. Please be aware that the drugs listed here are individual medications and may be part of a broader combination therapy. This information is meant to be a helpful resource but should not replace professional medical advice. If you're concerned about 'Artery dissection', it's best to consult a healthcare professional. In addition to 'Artery dissection', other symptoms or signs might better match your side effect. We have listed these below for your convenience. If you find a symptom that more closely resembles your experience, you can use it to identify potential medications that might be the cause.Advertisement
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Incidence Of Spontaneous Coronary Artery Dissection On The Rise, Finds Study
Incidence of Spontaneous coronary artery dissection is on the rise finds study published in the International Journal of Cardiology.
Spontaneous coronary artery dissection (SCAD) has been described as an infrequent cause of acute coronary syndrome (ACS). Knowledge about the disease is still limited and SCAD might still be underdiagnosed.
Patients with SCAD between 1997 and 2021 at the University Hospital Zurich, Switzerland, were included. Incidences were assessed as total numbers and proportions of ACS cases. Clinical data were collected from medical records and angiographic findings were reviewed. Major adverse cardiac events (MACE) were defined as the composite of all-cause death, cardiac arrest, SCAD recurrence or progression, other myocardial infarction, and stroke.
Results
One hundred fifty-six SCAD cases were included in this study. The incidence increased significantly in total (p < 0.001) and relative to ACS cases (p < 0.001). This was based on an increase of shorter lesions (p = 0.004), SCAD type 2 (p < 0.001), and lesions in side branches (p = 0.014), whereas lesions in the left main coronary artery and proximal segments were decreasing (p-values 0.029 and < 0.001, respectively). There was an increase in conservative therapy (p < 0.001). The rate of MACE (24%) was stable, however, there was a reduced proportion of patients with a need for intensive care treatment (p = 0.017).
SCAD represents an important entity of ACS that still might be underappreciated. The increasing incidence of SCAD is likely based on better awareness and familiarity with the disease. A lower need for intensive care treatment suggests positive effects of the increasing implementation of conservative management.
Reference:
Michael Würdinger, Victor Schweiger, Thomas Gilhofer, Victoria L. Cammann, Annika Badorff, Iva Koleva, Davide Di Vece, David Niederseer, Alessandro Candreva, Jonathan Michel, Alexander Gotschy, Julia Stehli, Barbara E. Stähli, Jelena R. Ghadri, Christian Templin. Twenty-five-year trends in incidence, angiographic appearance, and management of spontaneous coronary artery dissection, International Journal of Cardiology,Volume 395,
2024,131429,ISSN 0167-5273,https://doi.Org/10.1016/j.Ijcard.2023.131429.
(https://www.Sciencedirect.Com/science/article/pii/S0167527323014596)
Keywords:
Incidence, Spontaneous, coronary artery, dissection, rise, International Journal of Cardiology, Spontaneous coronary artery dissection; SCAD; Trends; Incidence; Types; Management, Michael Würdinger, Victor Schweiger, Thomas Gilhofer, Victoria L. Cammann, Annika Badorff, Iva Koleva, Davide Di Vece, David Niederseer, Alessandro Candreva, Jonathan Michel, Alexander Gotschy, Julia Stehli, Barbara E. Stähli, Jelena R. Ghadri, Christian Templin
Spontaneous Coronary Artery Dissections: Treatment Recommendations Still Unheeded
Consensus recommendations for spontaneous coronary artery dissection (SCAD) have been applied inconsistently despite increasing awareness of this condition, according to a meta-analysis.
Observational studies showed significant variations in clinical practice around the world, particularly for fibromuscular dysplasia (FMD) screening, which had a large range of implementation rates, with the Middle East at the low end (0.6%) and North America at the high end (60.5%).
"This is despite the well-known association between SCAD and FMD, with screening recommended in all patients to look for extracardiac vascular manifestations," wrote Sarah Zaman, MBBS, PhD, of the University of Sydney and Westmead Hospital in Australia, and colleagues in Open Heart.
They reported that other recommendations from the first scientific statements on the management of SCAD -- published in 2018 by the American Heart Association and the European Society of Cardiology -- also appeared to be applied in the real world to varying degrees:
"An improvement in adherence to recommended therapies is thus needed. Raising awareness among clinicians about these recommendations, together with further prospective evidence on their effectiveness in reducing [major adverse cardiovascular events], may help improve quality of care for patients with SCAD," Zaman's group concluded.
They noted that the data they analyzed suggested little change in adherence to consensus recommendations before and after they were published in 2018 -- "likely a consequence of later studies including patients recruited historically, diluting any change in the quality-of-care with time."
SCAD is increasingly recognized as a cause of acute coronary syndrome, particularly in women younger than 50. Such tears in the wall of the epicardial coronary artery are not as rare as previously thought, with the study authors reporting "nearly eight times the number of patients studied in the past 4 years, compared with the 30 years prior."
Nevertheless, there are no randomized data to guide treatment for SCAD.
In its 2018 statement, the American Heart Association said that SCAD is best treated conservatively with in-hospital monitoring rather than invasive treatment. Newer observational data indeed suggested that SCAD patients who had presented with heart attacks and were largely treated conservatively had surprisingly favorable outcomes in the long run.
Antiplatelets and beta-blockers remain controversial as medical therapy for SCAD, Zaman and colleagues noted.
For their study, the group had performed a systematic review pooling 53 studies with 8,456 SCAD patients (mean age 50.1 years, 90.6% women) in 22 countries. These were a mix of retrospective and prospective studies, with 39 out of the 53 reports published from 2018 to 2022.
On random effects meta-analysis, 92.1% of patients received at least one antiplatelet, 78.0% received beta-blockers, 58.7% received ACE inhibitors or ARBs, and 54.4% were screened for FMD.
Although 70.2% of SCAD patients were ostensibly referred to cardiac rehabilitation, this outcome was reported only from North America.
"This systematic review is limited by the under-reporting of several quality-of-care measures, particularly cardiac rehabilitation and FMD screening. We were also unable to determine use of single versus dual antiplatelet therapy in many studies," Zaman's group cautioned.
"Most of the studies included in our systematic review were from higher-income countries, highlighting a paucity of data from lower-income countries. It is possible that adherence would be lower than our current data, particularly for FMD screening and rehab referral, due to limitations in resources in these countries," they added.
Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow
Disclosures
Zaman disclosed support by a Heart Foundation Fellowship and a New South Wales Health Cardiovascular Research Elite Postdoctoral Grant.
Primary Source
Open Heart
Source Reference: Dang Q, et al "Regional and temporal variations of spontaneous coronary artery dissection care according to consensus recommendations: a systematic review and meta-analysis" Open Heart 2023; DOI: 10.1136/openhrt-2023-002379.
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