Key result
Non-obstructive CAD in ACS is linked to ~30% lower 3-month heart failure risk versus obstructive CAD.
Why the study?
Differences in prognosis and baseline clinical presentation between ACS patients with obstructive and non-obstructive coronary artery disease have been documented, but event rates varied across studies.
Does non-obstructive coronary artery disease compared to obstructive coronary artery disease result in different in-hospital and 3-month MACE rates in patients with acute coronary syndrome?
Observational (n=200)
Yes
Does non-obstructive coronary artery disease compared to obstructive coronary artery disease result in different in-hospital and 3-month MACE rates in patients with acute coronary syndrome?
Absolute Event Rate: 19% vs 27%
p-value: p=0.007
Patients with ACS and non-obstructive CAD have a more favorable clinical profile and fewer complications at 3 months compared to those with obstructive CAD.
May inform short-term prognosis in ACS; leaves open whether non-obstructive cases warrant distinct management pending prospective trials.
Background and aim: Differences in prognosis and baseline clinical presentation have been documented among patient with acute coronary syndrome and coronary artery disease with obstructive (ObCAD) or nonobstructive arteries (NObCAD), but the rates of events largely varied across single studies, the present study aimed to compare the clinical profile, in-hospital and 3-month outcomes major adverse cardiovascular events (MACEs) of Acute Coronary Syndrome (ACS) patients with Non – Obstructive Coronary Diseases (NOCAD), versus Obstructive Coronary Diseases (OCAD). Patients and methods: This prospective observational study included 200 consecutive patients admitted with the diagnosis of ACS to Coronary Care Unit (CCU) at Al- Azhar University hospital Assiut and Sohag Specialized Cardiac and Digestive System Center. Results: There was statistically significant increase in patients suffered from common complication of ACS during 3 months follow up in group B (CAD) than group A (NOCAD).There was statistically significant between number of vessels in both groups with heart failure, and recurrent angina pain complications. Conclusion: Female sex, young age, less diabetic patients, less smoking, less ST segment changes, elevations in peak troponin levels were all associated with coronary angiography showing no significant stenosis.
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Elsalam et al. (2022) conducted an observational in Acute Coronary Syndrome (n=200). Non-obstructive coronary artery disease (NOCAD) vs. Obstructive coronary artery disease (OCAD) was evaluated on Heart failure at 3 months (p=0.007). Patients with acute coronary syndrome and non-obstructive coronary artery disease had significantly lower rates of 3-month complications, including heart failure (19% vs 27%) and recurrent angina (12% vs 24%), compared to those with obstructive disease.
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