Three-year follow-up in patients with acute coronary syndrome and normal coronary angiography

OBJECTIVE: The present study was conducted to compare the clinical outcomes and investigate prognostic factors of acute coronary syndrome (ACS) in patients with normal coronary angiography. METHODS: The study was a retrospective cohort of 736 adult patients admitted with ACS between April 2007 and March 2008. After 3 years of follow-up, data regarding the following endpoints were obtained: death (cardiac and noncardiac), nonfatal myocardial infarction, and recurrent angina leading to repeated coronary angiography. The analysis focused on patients with a culprit lesion (n=678) and on those without a culprit lesion (n=51). RESULTS: Major adverse cardiac events (MACEs) were significantly more frequent in the group with culprit lesions than in the group without culprit lesions (P<0.05). The frequency of MACE-free survival was significantly lower in the group with culprit lesions than in the group without culprit lesions (P=0.0016). Diabetes mellitus was a significant independent predictor of poor prognosis. CONCLUSION: ACS patients without culprit lesions have an excellent prognosis for MACE after 3 years of follow-up compared with patients with obstructive ACS. Diabetes mellitus predicts adverse outcome in ACS patients.