Contemporary trends in the incidence of spontaneous coronary artery dissection (SCAD) – ethnic and household income disparities

ABSTRACT

Objectives

Spontaneous coronary artery dissection (SCAD) may contribute to 35% of acute coronary syndrome among women ≤50 years of age. We aimed to investigate the overall incidence, as well as the trends of SCAD incidence based on race, household income, and the U.S. census regions utilizing the National Inpatient Sample.

Methods

In this retrospective cohort study the discharge data were extracted from the NIS using 9th and 10th revisions of the International Classification Disease for SCAD.

Results

We found that the incidence of SCAD is rising in all U.S. census regions, and patients were predominantly females. Overall crude incidence of SCAD per 1,000,000 discharges per year was found to be 4.95 (2010), 5.73 (2011), 5.34 (2012), 6.18 (2013), 7.64 (2014), 8.11 (2015), 14.58 (2016), and 14.81 (2017). There was a higher incidence of SCAD in white population and higher-income groups. Among U.S. census regions, West has had the highest incidence followed by the Northeast, Midwest, and South. Statistically significant differences were observed in year-to-year SCAD incidence among racial groups, household income quintiles, and U.S. census regions (P < 0.0001).

Conclusion

Recent trends indicate that the incidence is highest among White race, highest household income quintile, and in U.S. CENS-R4 (Census Region 4: West). These findings defy classic racial trends in cardiovascular disease burden which need further discovery.

KEYWORDS:

• Spontaneous coronary artery dissection
• incidence
• healthcare disparities
• trends
• income

Declaration of Interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

MS Mughal: Conceptualization, Methodology, Writing-original draft, Writing-review & editing, had full access to all the data in the study and takes responsibility for the integrity of the data. H Akbar, IP Kaur, AR Ghani, and H Mirza: Writing-original draft, Writing-review. W Xia: Data curation and Statistical analysis. MH Usman, M Alam, T Helmy: Project administration, Supervision, Validation of intellectual content, critical revision and the final approval of the version to be published; and that all authors agree to be accountable for all aspects of the work.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.