Hospital Readmission in Patients With Spontaneous Coronary Artery Dissection

Spontaneous coronary artery dissection (SCAD) can present with various clinical symptoms, including chest pain, syncope, and sudden cardiac death, particularly in those without atherosclerotic risk factors. In this contemporary analysis, we aimed to identify the causes and predictors of 30-day hospital readmission in SCAD patients. We utilized the latest Nationwide Readmissions Database from 2016 - 2017 to identify patients with a primary discharge diagnosis of SCAD. The primary outcome was 30-day readmission. Among 795 patients admitted with a principal discharge diagnosis of SCAD, 85 (11.3%) were readmitted within 30 days of discharge from index admission (69.8% women, mean age of 54.3 ± 0.8). More than half of the readmissions (57%) were cardiac-related readmissions. Common cardiac causes for 30-day hospital readmission were acute coronary syndrome (27.3%), chest pain/unspecified angina (24.6%), heart failure (17.5%), and recurrent SCAD (8.3%). In conclusion, we found that following hospitalization for SCAD, almost one-tenth of patients were readmitted within 30 days, largely due to cardiac cause. Risk stratifying patients with SCAD, identifying high-risk features or atypical phenotypes of SCAD, and using appropriate management strategies may prevent hospital readmissions and reduce healthcare-related costs. Further studies are warranted to confirm these causes of readmission in SCAD patients.