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Serbian Registry Updates SCAD Profile and Early Outcomes, Pointing Clinicians Toward Conservative Care

Presented at the EAPCI Summit, the data support a shift to careful medical management guided by better use of intracoronary imaging.

Overview

  • Serbian SCAD Registry analysis of 123 cases from 14 centers (Nov 2021–Nov 2024) found 85.4% were women with a mean age of 47.5 years.
  • Non-pregnant younger and menopausal patients featured prominently, with hypertension (49.6%) and dyslipidaemia (46.3%) common and mental stress the leading reported trigger (38.5%).
  • Intracoronary imaging confirmed diagnosis in 26.0% of patients, highlighting opportunities to improve diagnostic accuracy.
  • In-hospital MACE occurred in 23.6% with 8.1% mortality; at 30 days, MACE was 18.1% with 0.8% mortality, and complete resolution was seen in 62.2%.
  • PCI was performed in 41.5% and stents in 28.5%, yet stent implantation and depression independently predicted MACE, reinforcing recommendations for conservative therapy and further trials alongside the ESC’s larger multinational registry.