Risks and benefits of PCI intervention in SCAD

Study looks at whether SCAD patients should have angiograms

A new study investigating the practice and complications of PCI in SCAD patients has been published.

Using data from SCAD patient registries in the UK, Netherlands and Spain, this study, co-written by Dr David Adlam and colleagues on the UK research project, is the largest international observational study of PCI in SCAD. It looked at 215 SCAD patients who had undergone PCI and 221 who had been managed conservatively.

Although conservative management is preferred where possible, some patients may need intervention to reduce the risk of greater heart injury. However, there is a higher risk of complications when PCI is used in SCAD and patients sometimes need longer stents than might be used for atherosclerotic heart disease.

“While a conservative approach to revascularisation is favoured, SCAD cases with higher risk presentations may require PCI. SCAD-PCI is associated with longer stent lengths and a higher risk of complications but leads to overall improvements in coronary flow and good medium-term outcomes in patients,” said the study.

Dr Adlam, Associate Professor of Acute and Interventional Cardiology at University of Leicester & Honorary Consultant Interventional Cardiologist at University Hospitals Leicester and lead SCAD researcher, added: “There are definitely situations were stenting is the right thing to do. We don’t want the pendulum to swing too far in favour of conservative treatment when you have a more serious scenario, greater risk in terms of the heart muscle, and maybe in those cases you should, accepting those extra risks, still intervene in a careful and appropriate fashion.”

Beat SCAD asked Dr Adlam about the significance of this paper and the new chapter on SCAD in the PCI textbook. He said it’s important that clinicians who are reading the guidelines for healthcare professionals (eg NICE guidelines) are aware that SCAD is different in terms of PCI, so it’s important that this information keeps being shared and is available to clinicians dealing with SCAD.

Thanks to everyone who has signed up for and taken part in the research. Dr Adlam said: “A huge thanks to all volunteers – SCAD patients, families and healthy volunteers – because without you we wouldn’t have any of these data to analyse so we couldn’t publish these papers that take us forward with SCAD.”

Beat SCAD would also like to thank all the researchers across the world who continue to search for answers and establish best practice for managing SCAD patients.

Click here to watch Dr Adlam discuss the paper with Trustee Rebecca Breslin.

Dr Adlam
Dr David Adlam