Objective:

To compare the clinical presentations and outcomes of pregnancy-associated spontaneous coronary artery dissection (P-SCAD) with nonpregnancy spontaneous coronary artery dissection (non-P-SCAD).

Key Findings:

• P-SCAD patients experienced more severe clinical presentations than non-P-SCAD patients, including higher rates of fertility treatment use and preeclampsia.
• Higher rates of ST-segment elevation myocardial infarction (STEMI) were observed in P-SCAD (18.6%) compared to non-P-SCAD (5.5%).
• P-SCAD was associated with multivessel and multisegment disease.
• Patients with P-SCAD had a higher likelihood of having a history of more than five pregnancies.
• In-hospital major adverse cardiovascular events were more frequent in P-SCAD patients, primarily due to recurrent myocardial infarction.
• P-SCAD patients had lower left ventricular ejection fraction (LVEF) at 1 year, indicating less recovery.

Interpretation:

The study highlights significant differences in the severity and outcomes of SCAD in pregnant versus non-pregnant patients, emphasizing the need for further research on long-term recovery and optimal management strategies.

Limitations:

• Small sample sizes may limit the interpretation of the study's findings, potentially affecting the generalizability of the results.

Conclusion:

Conservative management is common in both P-SCAD and non-P-SCAD groups, but P-SCAD is associated with more severe presentations and poorer recovery outcomes.