Saw J, et al. - In this multicenter, prospective, observational study, researchers examined the natural history of spontaneous coronary artery dissection (SCAD) among 750 prospectively enrolled patients with non-atherosclerotic SCAD presenting acutely from 22 centers in North America. For this analysis, they obtained information on baseline demographics, in-hospital characteristics, precipitating/predisposing conditions, angiographic features (assessed by core laboratory), in-hospital major adverse events (MAE), and 30-day major adverse cardiovascular events (MACE). Participants had mean age of 51.8 ± 10.2 years, 88.5% were women (55.0% postmenopausal), 87.7% were Caucasian, and 33.9% had no cardiac risk factors. Fibromuscular dysplasia (31.1%), systemic inflammatory diseases (4.7%), peripartum (4.5%), and connective tissue disorders (3.6%) comprised reported predisposing conditions. The noted that 30-day MACE was 8.8%. Independent predictors of 30-day MACE were peripartum SCAD and connective tissue disease. According to findings, SCAD mainly impacts women and presents with myocardial infarction. Although most patients received conservative treatment, survival was good. Significant cardiovascular complications, however, occurred within 30 days.