However, many of these studies were limited by a small sample size or a short duration of follow-up. Other studies reported a substantial risk in non-obstructive group with higher all-cause mortality or similar risk of combined death, MI, admission for ACS, and non-fatal stroke compared with obstructive CAD group. Previous studies showed that patients with NSTEMI with non-obstructive CAD had better prognosis compared with obstructive CAD.
Previous studies suggested that factors predicting non-obstructive coronary arteries in MI patients are female, younger age, and lack of smoking and diabetes mellitus (DM). Studies investigating this subgroup reported a wide range of prevalence (4–13%) according to the definitions used, the type of MI, and the use of cardiac troponin (MI or acute coronary syndrome (ACS)). Non-ST-segment elevation myocardial infarction (NSTEMI) with non-obstructive coronary arteries proven with coronary angiography is an important subgroup of patients with myocardial infarction (MI), because they are often managed differently, being less likely to receive recommended medical treatment after MI and more likely to discontinue double platelet inhibitors, than patients with NSTEMI with obstructive CAD. Patients with diffuse atherosclerosis have worse prognosis than those with angiographically normal coronary arteries. Patients with NSTEMI and non-obstructive CAD (both normal coronaries and diffuse atherosclerosis) have a comparable prognosis to patients with one- or two-vessel disease. For patients with DA mortality and HF risks were higher than 1VD and not different than 2VD, while recurrent MI risk was not different than 1VD and lower than 2VD.įinally, the DA group had higher risk of mortality if they had DM, higher risk of recurrent MI, and not different risk of HF and stroke compared with the 0VD group patients. Non-diabetic 0VD patients had higher risk of mortality than 1VD patients (HR:1.59 95% CI:1.21–2.02 P < 0.001), while those with diabetes mellitus (DM) had not significantly different risk. One-year mortality for NSTEMI patients with 0VD was 3.7%, DA 5.7%, 1VD 2.5%, 2VD 4.8%, and 3VD 11.5%. Patients were classified by CAG into: 0-vessel disease (0VD), diffuse atherosclerosis (DA) (0% < stenosis <50%), 1-vessel disease (1VD), 2VD, and 3VD with stenosis ≥50%. We examined 8.889 consecutive patients admitted for first time NSTEMI during 2000–2011, to whom CAG was performed.
Patients with non-ST-segment elevation myocardial infarction (NSTEMI) without obstructive coronary artery disease (CAD) are often managed differently than those with obstructive CAD, therefore we aimed in this study to examine the long-term prognosis of patients with NSTEMI according to the degree of CAD on coronary angiography (CAG).
0 kommentar(er)
