Overview
- The Mayo Clinic OCTOPUS study, published in JACC on September 15, analyzed 4,116 troponin-positive events in 2,790 people aged 65 and under from 2003 to 2018.
- Traditional artery blockages caused 47% of heart attacks in younger women versus 75% in men, with spontaneous coronary artery dissection (SCAD) accounting for 11% in women and under 1% in men.
- SCAD was initially misdiagnosed in 55% of cases, raising concern that treating it like a plaque-based heart attack can lead to harmful procedures such as unnecessary stenting.
- Secondary heart attacks tied to other medical crises had the highest five-year mortality at 33%, whereas the cohort reported no deaths among SCAD patients during follow-up.
- Women had lower overall heart attack rates, yet those with plaque-based events showed similar angiographic disease burden to men and higher rates of diabetes and hypertension, underscoring the need for targeted imaging and specialist review.