Abstract 4369731: Menopausal Symptom Burden in Peri and Postmenopausal Women With Spontaneous Coronary Artery Dissection

Background: Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome in women. Although the role of sex-hormones in the pathogenesis of SCAD is unclear, menopausal hormone therapy (HT) after SCAD is generally dissuaded. This limits management options for women with menopausal symptoms, the burden of which among SCAD patients is unknown. Aims: To quantify the burden of menopausal symptoms among women with a history of SCAD. Methods: We surveyed 1617 participants in the Mayo Clinic SCAD "Virtual" Multi-Center Registry on the topic of menopausal symptoms. Among women who had completed key portions of the survey (N = 846), 666 were identified as being either peri or post-menopausal based on patient report. Results: Menopausal symptom prevalence was high in women with SCAD (Figure). Many women (45%) experienced weight changes in the prior 6 months, and most (75%) never used HT for their menopausal symptoms. Forty-five (6%) women experienced menopause at age 45 or younger, and five (1%) experienced menopause at 40 or younger. At the time of the survey, intravaginal estrogen (11.4%) was the most common HT used, while all other individual HT therapies were used by fewer than 5%. Conclusions: Peri- and postmenopausal women with SCAD experience a high burden of menopausal symptoms, and very few use HT outside of intravaginal estrogen. These findings highlight the need for further exploration of treatment strategies for women with menopausal symptoms following SCAD including assessment of benefits versus harms in the subset of women with premature menopause.