Spontaneous Coronary Artery Dissection - AntipLatelet therapy Intensity in Guided coNservative management (SCAD-ALIGN-DZHK31)

The SCAD-ALIGN study is the first randomized clinical trial to investigate the optimal antiplatelet therapy in patients with spontaneous coronary artery dissection (SCAD). SCAD is a rare cause of acute coronary syndrome that predominantly affects women between 30 and 55 years of age and typically occurs in the absence of atherosclerotic vascular disease. Instead of a thrombotic vessel occlusion, bleeding within the vessel wall leads to impaired blood flow in the coronary artery.

In clinical practice, patients with SCAD are often treated according to guidelines for acute coronary syndrome, although the underlying mechanisms differ significantly. The study therefore evaluates whether a less intensive antiplatelet strategy may be more beneficial compared to standard therapy.

Two treatment strategies are compared: a three-month monotherapy with a single antiplatelet agent and a more intensive combination therapy for three months followed by nine months of monotherapy. The primary endpoint includes recurrent myocardial ischemia, recurrent SCAD, myocardial infarction, need for revascularization, and mortality.

This international, multicenter study is coordinated by the German Centre for Cardiovascular Research and conducted within a global funding initiative. The aim is to establish an evidence-based foundation for the treatment of SCAD and to sustainably improve care for affected patients.

Publications

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Principal Investigators

Principal investigator (Sponsor): Stefan Blankenberg (Hamburg), Co-PI: Peter Clemmensen (Hamburg), PI for Germany: Christina Magnussen (Hamburg)