Characteristics of Wellens syndrome patients in acute coronary syndrome: a retrospective study

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Wellens syndrome in acute coronary syndrome (n=50). Intervention: Elevated troponin T vs. Non-elevated troponin T. Primary outcome: Acute heart failure (adjusted OR 7.91, 95% CI 1.80-34.68, p=0.006).

Q: What does this research mean for the field?

Elevated troponin T is independently associated with an increased risk of acute heart failure in acute coronary syndrome patients with Wellens syndrome. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Nghia Phu Nguyen; Thuong Pham Hoai; Quoc Huy Luu; Phuc Minh Ha Vu; Ai Cao My Bui; Vũ Hoàng Vũ

doi:10.1186/s13104-026-07905-4

August 13, 2026BMC Research NotesOpen Access

Characteristics of Wellens syndrome patients in acute coronary syndrome: a retrospective study

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Key result

Elevated troponin T linked to ~8-fold higher acute heart failure risk in Wellens syndrome.

adjusted OR 7.91
95% CI 1.80-34.68
P=0.006
n=50

Why the study?

To determine the prevalence, clinical characteristics, coronary angiographic patterns, and factors associated with acute heart failure among patients with Wellens syndrome in a Vietnamese acute coronary syndrome cohort.

Key Points

To evaluate the prevalence, clinical characteristics, coronary angiographic patterns, and factors associated with acute heart failure in acute coronary syndrome patients with Wellens syndrome.
Retrospective review of 938 patients admitted with acute coronary syndrome at a tertiary cardiac center in Vietnam.
Identified 50 patients (5.3%) meeting electrocardiographic criteria for Wellens syndrome who underwent coronary angiography.
Assessed clinical, demographic, angiographic, and biomarker variables associated with acute heart failure using univariate and multivariable logistic regression.
Wellens syndrome occurred in 5.3% (50/938) of patients, presenting as type B in 52% and type A in 48%, with coronary angiography identifying left anterior descending artery lesions in 92% (proximal 78%, mid 66%) and multivessel disease in 46%.
Acute heart failure occurred in 42% of patients overall, affecting 53.9% of those with type B morphology compared to 29.2% with type A morphology.
Elevated troponin T was independently associated with acute heart failure in multivariable logistic regression (adjusted OR 7.91; 95% CI 1.80–34.68; p = 0.006).

Study Design

Type

Observational (n=50)

Multicenter

No

Structured PICO

P

Population

50 adults (mean age 64 years, 54% female) with acute coronary syndrome and Wellens syndrome evaluated retrospectively at a single center in Vietnam.

O

Outcome

Factors associated with acute heart failure (AHF) during admissionhard clinical

Main Result

Odds Ratio: 7.91 (95% CI 1.8–34.68)

p-value: p=0.006

In patients with Wellens syndrome, acute heart failure is common (42%) and is strongly associated with elevated troponin T levels, reflecting the extent of myocardial injury.

Limitations

Single-center, retrospective design with a modest sample size and relatively short study period
Potential selection bias due to recruitment from a tertiary cardiac center
Absence of a contemporaneous comparison group of non-Wellens NSTE-ACS patients
Incomplete echocardiographic assessment
The relatively small number of outcome events limited the events-per-variable ratio in the multivariable logistic regression
Single-center, retrospective design with a modest sample size and relatively short study period, limiting statistical power.
Potential selection bias due to recruitment from a tertiary cardiac center, which may limit generalisability.
Absence of a contemporaneous comparison group of non-Wellens NSTE-ACS patients.
Incomplete echocardiographic assessment, as parameters of diastolic function and right ventricular performance were not routinely recorded.
The relatively small number of outcome events limited the events-per-variable ratio in the multivariable logistic regression, which may affect model stability.

Implication

May warrant closer HF surveillance when Wellens pattern is seen in ACS; leaves open confirmation beyond this single-center Vietnamese cohort.

Abstract

This study aimed to determine the prevalence, clinical characteristics, coronary angiographic patterns, and factors associated with acute heart failure among patients with Wellens syndrome in a Vietnamese acute coronary syndrome cohort. Among 938 patients admitted with acute coronary syndrome, 50 patients (5.3%) fulfilled electrocardiographic criteria for Wellens syndrome. The mean age was 64.0 ± 7.8 years, and 54% were female. Cardiovascular risk factors were highly prevalent, including dyslipidemia (92%), hypertension (88%), diabetes mellitus (64%), and smoking (52%). Type B Wellens morphology was slightly more frequent than type A (52% vs. 48%). Coronary angiography demonstrated predominant involvement of the left anterior descending artery, most commonly affecting the proximal (78%) and mid (66%) segments, with multivessel disease present in 46% of patients. Acute heart failure occurred in 42% of cases. In multivariable logistic regression analysis, elevated troponin T was associated with acute heart failure (adjusted odds ratio 7.91 (95% CI 1.80–34.68), p = 0.006) and may reflect the extent of myocardial injury.

Discussion

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Cite This Study

Nguyen et al. (2026) conducted an observational in Wellens syndrome in acute coronary syndrome (n=50). Elevated troponin T vs. Non-elevated troponin T was evaluated on Acute heart failure (adjusted OR 7.91, 95% CI 1.80-34.68, p=0.006). Elevated troponin T was independently associated with acute heart failure in patients with Wellens syndrome (adjusted OR 7.91).

synapsesocial.com/papers/6a8019ce75c2e31742c85ea7 https://doi.org/10.1186/s13104-026-07905-4

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Characteristics of Wellens syndrome patients in acute coronary syndrome: a retrospective study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Characteristics of Wellens syndrome patients in acute coronary syndrome: a retrospective study

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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