NZ part of world-first trial into condition that causes heart attacks in young women

Spontaneous coronary artery dissection is the cause of a third of heart attacks in women under 50 and half of all heart attacks in pregnancy. Photo / 123rf

By Rowan Quinn of RNZ

New Zealanders will be part of a world-first clinical trial into how to treat a dangerous condition that causes heart attacks in young women – including new mothers.

There has been a lack of research into heart conditions that affect women specifically, and the work is part of a big push to change that.

Spontaneous coronary artery dissection (SCAD) occurs when a tear forms in the artery. It is the cause of a third of heart attacks in women under 50 and half of all heart attacks in pregnancy.

The condition is often missed when patients turn up to hospital with chest pain because otherwise-healthy, young women are not considered high risk for heart attacks.

The Heart Foundation is helping to fund the research. Clinical director Gerry Devlin said he hoped it would lead to better, potentially life-saving, understanding.

“It’s a really important trial. It will help define guidelines around the world about how we manage people presenting with this,” he said.

SCAD is different to other heart attacks.

“What happens is rather than the silting up that occurs in arteries over many years that can cause a blockage, with SCAD you get a tear in the wall of the artery and that tear can extend and lead to a blockage in the heart itself and cause a heart attack.”

Heart attack patients are commonly treated with blood thinners – sometimes aspirin, sometimes aspirin plus another drug.

But it is unclear what is the best option for people with SCAD because blood thinners could potentially exacerbate the effects of the tear, Devlin said.

The work will look at whether to try one blood thinner or two and whether the timing of the medication made a difference.

Fifty New Zealanders will take part in the global trial of 3250 people.

They will be selected after turning up at hospital with the condition.

Devlin said New Zealand is part of a network of heart funders and researchers around the world working together.

“What we are trying to do is create an environment where we can get clinical trials answering important questions done much more quickly by the power of doing it in many countries,” he said.

Many previous heart attack studies have tended to focus more on middle-aged men but there is now understanding that what works for men may not work for women.

Devlin said he had never treated a man with SCAD.

The condition is being identified more now because of improvements in diagnostic imaging and it is likely it will prove to be more prevalent than first realised as the technology improves and expands, he said.

The trial is one of 31 research projects given grants totalling $4.2 million announced by the Heart Foundation today.

The foundation has given away $99m for research since it first began in 1968.