What question did this study set out to answer?

The aim is to compare clinical presentation and prognosis between patients with obstructive and nonobstructive coronary artery disease in acute coronary syndrome.

December 1, 2016Journal of the American Heart AssociationOpen Access

Nonobstructive Versus Obstructive Coronary Artery Disease in Acute Coronary Syndrome: A Meta‐Analysis

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Why the study?

Does nonobstructive coronary artery disease compared to obstructive coronary artery disease affect the risk of death or major cardiovascular events in patients with acute coronary syndrome?

Key Points

The aim is to compare clinical presentation and prognosis between patients with obstructive and nonobstructive coronary artery disease in acute coronary syndrome.
Conducted searches in MedLine, EMBASE, Cochrane databases up to June 30, 2015.
Utilized random-effect meta-analyses to compare risks of cardiovascular events between NObCAD and ObCAD patients.
Estimated yearly and monthly outcome rates for each group.
NObCAD patients showed lower rates of all-cause mortality (2.4% vs 10.1%) and myocardial infarction (1.2% vs 6.0%).
Combined outcomes for NObCAD versus ObCAD included significantly lower major cardiovascular events (9.2% vs 16.8%) with risk ratios between 0.33 and 0.66.
No differences in outcomes were noted between patients with mild occlusion and those with zero occlusion.

Structured PICO

Does nonobstructive coronary artery disease compared to obstructive coronary artery disease affect the risk of death or major cardiovascular events in patients with acute coronary syndrome?

Population

Patients with acute coronary syndrome

Intervention

Nonobstructive coronary artery disease (NObCAD)

Comparator

Obstructive coronary artery disease (ObCAD)

Outcome

All-cause mortality, myocardial infarction, all-cause mortality plus myocardial infarction, cardiac death, and major cardiovascular eventshard clinical

Patients with acute coronary syndrome and nonobstructive coronary artery disease have a significantly lower risk of death and major cardiovascular events compared to those with obstructive disease, though their absolute risk remains substantial.

Discussion

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Implication

NObCAD signals lower event risk than ObCAD in ACS; reinforces angiographic severity for prognostic stratification and future trials.

Cite This Study

Pizzi et al. (2016) studied this question.

synapsesocial.com/papers/6a07b5e37ba19a189e06b32b https://doi.org/10.1161/jaha.116.004185

Topics

Coronary artery disease Women and heart disease Chronic total occlusion PCI

View Full Paper

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Bookmark

Nonobstructive Versus Obstructive Coronary Artery Disease in Acute Coronary Syndrome: A Meta‐Analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Nonobstructive Versus Obstructive Coronary Artery Disease in Acute Coronary Syndrome: A Meta‐Analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider