Abstract 15223: In-Hospital and Long-Term Clinical Outcomes of Spontaneous Coronary Artery Dissection Managed With Conservative versus Revascularization Strategy: A Meta-Analysis of Current Evidence

Background: Optimal treatment approach for spontaneous coronary artery dissection (SCAD) remains unclear. Objectives: The study aims to compare in-hospital and long-term clinical outcomes of SCAD patients initially managed with medical therapy (conservative approach) versus percutaneous coronary intervention or coronary artery bypass grafting (revascularization approach) based on published data. Methods: We identified relevant studies by performing a systematic search in the Ovid MEDLINE® and Embase database. Studies that report in-hospital outcomes (death, myocardial infarction [MI], and urgent revascularization) or long-term outcomes (death, MI, target vessel revascularization [TVR], SCAD recurrence, and heart failure [HF]) were included and case reports were excluded. Risk difference (RD) between conservative and revascularization approach was estimated with the inverse variance-weighted method in a fixed-effect model. Results: The analysis includes 25 non-randomized studies totaling 1351 SCAD patients...