自发性冠状动脉夹层及其与纤维肌发育异常和其他血管异常的关系
OBJECTIVE
Fibromuscular dysplasia (FMD) has recently been associated with spontaneous coronary artery dissection (SCAD).
最近研究表明，纤维肌发育不良（FMD）与自发性冠状动脉夹层（SCAD）相关。我们试图进一步阐明两者间的关系。
METHODS
We sought to further elucidate the association of FMD with SCAD. We performed a retrospective cohort review of patients with SCAD evaluated at our institution from 2008 to 2019. Baseline characteristics, coronary angiographic data, and screening for FMD were recorded. In patients who completed screening for FMD, variables were compared between patients with FMD and those without. We identified 51 patients with SCAD, all of whom were female, with a mean age of 46.8 years.
2008年至2019年对在我们机构进行评估的SCAD患者进行了回顾性队列研究。记录了基线特征、冠状动脉造影数据和FMD筛查。完成FMD筛查的患者中，比较有FMD的患者和没有FMD的患者之间的变量。确定51例SCAD患者，全部为女性，平均年龄为46.8岁。
RESULTS
A quarter of patients underwent percutaneous coronary intervention (PCI) and half of those suffered a complication during PCI. 78% of patients underwent complete screening for FMD, of which 63% were diagnosed with multifocal FMD. Vascular abnormalities other than FMD were found in 70% of screened patients. Patients with FMD were older than those without FMD (50.7 vs 42.6 years, p = 0.006). FMD was more frequently associated with type 2 SCAD (84% vs 47%, p = 0.025), tortuous non-SCAD coronaries (96% vs 53%, p = 0.002), and other vascular abnormalities (84% vs 47%, p = 0.03).
四分之一患者接受了经皮冠状动脉介入治疗（PCI），一半患者在PCI期间发生了并发症。78％的患者接受了FMD的全面筛查，其中63％被诊断为多灶性FMD。在接受筛查的患者中，70％患者发现FMD以外的血管异常。FMD患者比没有FMD的患者年龄更大（50.7 vs 42.6岁，p = 0.006）。 FMD与2型SCAD（84％vs 47％，p = 0.025）、非SCAD冠状动脉病变（96％vs 53％，p = 0.002）和其他血管异常（84％vs 47％，p = 0.03）关联性较高。
CONCLUSIONS
In conclusion, the majority of patients within the all-female cohort with SCAD were found to have FMD. Other vascular abnormalities were also common. Patients with FMD were older and were more likely to have type 2 SCAD, tortuous non-SCAD coronary arteries, and other vascular abnormalities.
总之，在所有患有SCAD的女性队列中，大多数患者被发现纤维肌发育不良。其他血管异常也很常见。患有FMD的患者年龄较大，更可能患有2型SCAD、非SCAD冠状动脉和其他血管异常。
