Grant: Project Grant

Spontaneous coronary artery dissection (SCAD) occurs when there is a tear in the inner layers of a blood vessel in the heart, causing blockage and reduction of blood flow and oxygen to the heart. It is increasingly recognized as an important cause of heart attacks in women. However, it remains poorly understood and misdiagnosed. The management of SCAD is highly controversial, especially with the use of antiplatelet therapy and their potential risk for bleeding complications. The objective of the study is to establish optimal medical therapy by performing a randomized controlled trial (RCT) to compare the use of moderate single APT (SAPT) to intensive dual APT (DAPT). We propose a global, multicenter, open-label RCT comparing these medical regimens for patients presenting with acute SCAD. We will recruit patients from ~240 sites globally (e.g. United States, Australia, United Kingdom, Germany) including 25 centers in Canada with 280 Canadian patients, to complete the full analysis of 3,518 patients in total. We are seeking CIHR funding for Canadian enrollment, and we are expecting our international collaborators to seek grant funding applications for the remainder of the patient enrollment globally. This large global RCT will help generate guidelines for SCAD management.