Diagnóstico y manejo clínico de la disección coronaria espontánea

Abstract

Spontaneous coronary artery dissection (SCAD) is a disease that causes acute coronary syndromes mainly in middle-aged women. It isproduced by the separation of the arterial wall layers and the formation of a false lumen provoking myocardial ischaemia. There are many uncertainties regarding the causes, diagnostic features and clinical management of this disease. The present thesis aims to answer to different clinical questions through the study of cohorts and multicentre international registries of patients with SCAD. Firstly, the state of the art of the disease will be reviewed focusing on the gaps in evidence that are addressed with the studies presented hereby. Following this, 4 original research articles will be presented, which have their focuses in the following topics: i) differences in clinical presentation and prognosis between Takotsubo syndrome and SCAD in patients with common clinical profile i.e. middle-aged, predominantly women with few cardiovascular risk factors; ii) relationship of the distinct angiographic presentations (angiotypes) of SCAD with short- and long-term clinical outcomes; iii) long-term effectiveness and safety of bioresorbable stents in patients with high-risk SCAD undergoing percutaneous angioplasty; iv) use of magnetic resonance angiography for the study of non-coronary arteriopathy in patients with SCAD...