Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population
Why the study?
While significant CAD is linked to long-term adverse events, the study aimed to evaluate long-term MACE up to 5 years in patients presenting with chest pain without significant CAD.
What are the risk factors for MACE and sustained angina pectoris in patients presenting with chest pain without significant coronary artery disease?
Population
5890 subjects with chest pain without significant coronary artery disease
Design
Prospective cohort study
Follow-up
Mean 3.4 years
Authors
Discussion
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Implication
Age and insignificant stenosis identify higher MACE risk in nonobstructive chest pain; hypothesis-generating and should not yet change practice.
Key Points
- This study evaluates the long-term major adverse clinical events in patients with chest pain but without significant coronary artery disease.
- A total of 5890 patients with chest pain were prospectively enrolled.
- Mean follow-up duration was 3.4 years.
- Multivariable Cox proportional hazards regression analysis was used to identify independent risk factors for MACE.
- MACE occurred in 91 (2.2%) patients within 5 years (HR for age per 5 years: 1.44; 95% CI, 1.30-1.60).
- Risk factors for sustained angina included age (HR: 1.05; 95% CI, 1.01-1.11) and dyslipidemia (HR: 1.34; 95% CI, 1.06-1.70).
- Insignificant coronary stenosis was associated with increased MACE (HR: 2.03; 95% CI, 1.28-3.21) and angina (HR: 2.54; 95% CI, 1.94-3.31).
Structured PICO
What are the risk factors for MACE and sustained angina pectoris in patients presenting with chest pain without significant coronary artery disease?
P
Population
5,890 subjects with chest pain without significant coronary artery disease in the Korean population
I
Intervention
Presence of risk factors including aging, insignificant coronary stenosis (30%-70%), dyslipidemia, coronary artery spasm, and myocardial bridge
O
Outcome
Major adverse clinical events (MACE), defined as the composite of total death, myocardial infarction, coronary revascularization, stroke, and hospitalization because of heart failure up to 5 yearscomposite
In patients with chest pain but no significant coronary artery disease, aging and insignificant coronary stenosis (30-70%) are strong independent predictors of long-term MACE.
Cite This Study
Choi et al. (2019) studied this question.