Aspirin, blocker, clopidogrel, angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker for patients with hypertension, vascular abnormality imaging, and cardiac rehabilitation were some of the evidence-based medicine (EBM) standards currently in use for spontaneous coronary artery dissection (SCAD). The frequency of failure to satisfy EBM SCAD treatment criteria, as well as the reasons that contribute to noncompliance, were investigated in the study. Patients who presented to a tertiary referral hospital were included between January 1, 2005, and July 6, 2020. For EBM treatment, the electronic medical record was examined. Patients who did not satisfy the EBM criteria were contacted by phone and asked to participate in a phone interview. During the trial period, 118 patients with SCAD were enrolled, however, 3 of them (2.5%) died and were no longer eligible. The final cohort of 115 patients had an average age of 55 years, a female gender of 97%, and 30% met EBM requirements. Patients who took part in the phone conversation said they were frustrated by SCAD misdiagnosis (39%), insufficient mental health resources (37%), and a lack of communication about the necessity for cardiologist follow-up (265). Location, time of day, availability, and cost all influenced the usage of cardiac rehabilitation. Fatigue was the most common medication-limiting reason for -blocker use (15%). The majority of patients (59%) did not have fibromuscular dysplasia imaging. In conclusion, only 30% of the SCAD patients in the 15-year research from a single tertiary care hospital SCAD registry met the current EBM for SCAD. To obtain the best therapeutic outcomes, unique solutions that were both patient-centered and evidence-based were required.
Source:www.ajconline.org/article/S0002-9149(22)00114-X/fulltext
