Wellens syndrome as an independent predictor of in-hospital cardiovascular complications

• Published in: Acta Cardiologica 2023-08, Vol.ahead-of-print (ahead-of-print), p.1-7
• Main Authors: de la Torre Fonseca, Luis Mariano, Alarcón Cedeño, Robert, Jiménez Díaz, Víctor Alfonso, Wang, Lin, Loor Cedeño, Fabiola Isabel, Juan-Salvadores, Pablo
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - complications; Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - epidemiology; Aged; cardiovascular complications; Coronary Artery Disease; hospitalisation; Hospitals; Humans; Middle Aged; Myocardial Infarction; non-ST segment elevation acute coronary syndrome; percutaneous coronary interventions; Prospective Studies; Wellens syndrome
• ISSN: 0001-5385; 0373-7934; 1784-973X
• DOI: 10.1080/00015385.2022.2093797

Wellens Syndrome was described for the first time in the eighties, as an equivalent pattern of a critical lesion of the anterior descending artery. Different risk factors have been associated with a worse prognosis during hospitalisation in patients with non-ST segment elevation acute coronary syndrome. However, it is unknown whether the presence of Wellens Syndrome alone contributes to an increase in in-hospital cardiovascular complications. Analytical prospective cohort study in 141 patients with the diagnosis of acute coronary syndrome without ST segment elevation who underwent coronary angiography between 2016 and 2020. Wellens syndrome was diagnosed in 64 patients with a mean age of 66.31 ± 12.54, of which 21 patients had a cardiac event during hospitalisation: hemodynamic complication 14 (21.9%), refractory or recurrent angina 4 (6.3%) and Acute myocardial infarction 3 (4.7%) confirming a relative risk (RR): 4.88 (95% confidence interval (CI) 1.92-12.45) p = 0.001. The presence of Wellens Syndrome is independently associated with the appearance of cardiac complications during hospitalisation. Key points SW is now known to be a relatively frequent presentation of ACS, not addressed in depth in clinical practice guidelines for NSTEACS. This syndrome is generally caused by a severe ADA occlusion that, if not adequately treated, could evolve into a large infarction. According to the results of the different series published, the incidence of cardiovascular risk factors in SW is similar to other forms of presentation of ischaemic heart disease. At present, the exact relationship between the main cardiovascular risk factors and SW is unknown; in addition to the possible associations of this syndrome with in-hospital cardiovascular complications and its value as a predictor of the occurrence of cardiac complications, elements that are included in the results of the present study.