Monday, 23 March 2015

Study first to identify spontaneous coronary artery disease as inherited






Heart diagram. Credit: Wikipedia

A Mayo Clinic study has identified a familial association in spontaneous coronary artery dissection, a type of heart attack that most commonly affects younger women, suggesting a genetic predisposition to the condition, researchers say. The results are published in the March 23 issue of JAMA Internal Medicine.



Researchers used the Mayo Clinic SCAD Registry of 412 enrollees to identify five familial cases of SCAD, comprised of three pairs of first-degree relatives (mother-daughter, identical twin sisters, sisters) and two pairs of second-degree relatives (aunt and niece, and first cousins). Researchers believe this is the first study to identify SCAD as an inherited disorder.


Most heart attacks happen when plaque builds up in arteries over a lifetime, and causes a blockage and a heart attack. In SCAD, a tear occurs inside an artery, and that can cause a blockage, leading to a heart attack.


"I was taught that SCAD was rare and the causes entirely unknown, but through our partnership with SCAD survivors and their families, clues are emerging that may change that," says Sharonne Hayes, M.D., senior author and cardiologist at Mayo Clinic, Rochester, Minn. "We know from previous research that SCAD occurs most often in with no or minimal cardiovascular risk factors, like high blood pressure and high cholesterol. Recognizing now that it is a heritable disorder has implications for at-risk family members, and helps us understand the condition better."


In one example from the study, a 36-year-old woman had intermittent chest pain for 24 hours. She was diagnosed with a heart attack, and a coronary angiography (a procedure that uses X-ray imaging to see the heart's blood vessels) showed a spontaneous coronary dissection. Her only was . She had been training for a triathlon the week before her SCAD. Two years later, the woman's 44-year-old maternal cousin went to the hospital following two hours of radiating to her upper back. She also was diagnosed with SCAD. Her only factor was a history of smoking. She participated in a 75-mile bicycle ride three days before her .


In addition, subsequent testing in both women revealed fibromuscular dysplasia, a vascular condition which more recently has been associated with SCAD, Dr. Hayes says.


Dr. Hayes says it is not clear what causes SCAD in most cases, but researchers know this from previous studies:



  • SCAD affects women more often than men; up to 80 percent of patients with SCAD are women.

  • The average age is 42 years.

  • SCAD patients are typically otherwise healthy, with few heart disease risk factors.

  • About 20 percent of women SCAD patients have recently given birth.



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Heart diagram. Credit: Wikipedia


A Mayo Clinic study has identified a familial association in spontaneous coronary artery dissection, a type of heart attack that most commonly affects younger women, suggesting a genetic predisposition to the condition, researchers say. The results are published in the March 23 issue of JAMA Internal Medicine.



Researchers used the Mayo Clinic SCAD Registry of 412 enrollees to identify five familial cases of SCAD, comprised of three pairs of first-degree relatives (mother-daughter, identical twin sisters, sisters) and two pairs of second-degree relatives (aunt and niece, and first cousins). Researchers believe this is the first study to identify SCAD as an inherited disorder.


Most heart attacks happen when plaque builds up in arteries over a lifetime, and causes a blockage and a heart attack. In SCAD, a tear occurs inside an artery, and that can cause a blockage, leading to a heart attack.


"I was taught that SCAD was rare and the causes entirely unknown, but through our partnership with SCAD survivors and their families, clues are emerging that may change that," says Sharonne Hayes, M.D., senior author and cardiologist at Mayo Clinic, Rochester, Minn. "We know from previous research that SCAD occurs most often in with no or minimal cardiovascular risk factors, like high blood pressure and high cholesterol. Recognizing now that it is a heritable disorder has implications for at-risk family members, and helps us understand the condition better."


In one example from the study, a 36-year-old woman had intermittent chest pain for 24 hours. She was diagnosed with a heart attack, and a coronary angiography (a procedure that uses X-ray imaging to see the heart's blood vessels) showed a spontaneous coronary dissection. Her only was . She had been training for a triathlon the week before her SCAD. Two years later, the woman's 44-year-old maternal cousin went to the hospital following two hours of radiating to her upper back. She also was diagnosed with SCAD. Her only factor was a history of smoking. She participated in a 75-mile bicycle ride three days before her .


In addition, subsequent testing in both women revealed fibromuscular dysplasia, a vascular condition which more recently has been associated with SCAD, Dr. Hayes says.


Dr. Hayes says it is not clear what causes SCAD in most cases, but researchers know this from previous studies:



  • SCAD affects women more often than men; up to 80 percent of patients with SCAD are women.

  • The average age is 42 years.

  • SCAD patients are typically otherwise healthy, with few heart disease risk factors.

  • About 20 percent of women SCAD patients have recently given birth.



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Study reveals important clues about rare heart condition that strikes young, healthy women


Jul 16, 2012

Spontaneous coronary artery dissection (SCAD), a tear of the layers of the artery wall that can block normal blood flow into and around the heart, is a relatively rare and poorly understood condition. It often strikes young, ...



Mayo Clinic finds social media valuable tool to recruit study participants for rare diseases


Aug 30, 2011

Mayo Clinic has identified a new benefit of social media and online networking: a novel way to study rare diseases. Through patient-run websites dedicated to heart conditions and women's heart health, a team of cardiologists ...



Cardiologists can quickly detect coronary artery disease using a non-invasive simple, short respiratory stress test


May 13, 2010

Newly published data confirm a non-invasive Respiratory Stress Response (RSR) can quickly and accurately measure the presence of significant coronary artery disease (sCAD), the leading cause of cardiovascular death worldwide. ...



Patients with active asthma at higher risk for heart attack, research shows


Nov 16, 2014

Patients with active asthma—such as any use of asthma medications, and unscheduled office or emergency visits for asthma—are at a twofold risk of having a heart attack, according to Mayo Clinic research ...



CT scans appear to dramatically improve diagnosis of heart disease


Mar 16, 2015

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