Prognostic Implications of Coronary Artery Sclerosis in Troponin-Positive Patients with Non-Obstructive Coronary Arteries

• Published in: Cardiology and therapy 2024-09, Vol.13 (3), p.557-574
• Main Authors: Kreimer, Fabienne, Schlettert, Clara, Abumayyaleh, Mohammad, Akin, Ibrahim, Materzok, Daniel, Gotzmann, Michael, Schiedat, Fabian, Bogossian, Harilaos, Hijazi, Mido Max, Hamdani, Nazha, Mügge, Andreas, El-Battrawy, Ibrahim, Hemetsberger, Rayyan, Aweimer, Assem
• Format: Article
• Language: English
• Subjects: Atherosclerosis; Cardiology; Coronary artery disease; Internal Medicine; Medicine; Medicine & Public Health; Myocardial infarction with non-obstructive coronary arteries (MINOCA); Original Research
• ISSN: 2193-8261; 2193-6544
• DOI: 10.1007/s40119-024-00375-4

Introduction Coronary sclerosis is a risk factor for the progression to obstructive coronary artery disease (CAD). However, understanding its impact on the outcomes of patients with myocardial infarction and non-obstructive coronary arteries is limited. This study aimed to explore the prognostic influence of coronary sclerosis on in- and out-of-hospital events in troponin-positive patients with non-obstructive coronary arteries. Methods This study was a retrospective cohort analysis based on prospectively collected data. A total of 24,775 patients who underwent coronary angiography from 2010 to 2021 in a German university hospital were screened, resulting in a final study cohort of 373 troponin-positive patients with non-obstructive coronary arteries and a follow-up period of 6.2 ± 3.1 years. Coronary sclerosis was defined as coronary plaques without angiographically detectable stenotic lesions of 50% or more in the large epicardial coronary arteries. The primary study endpoint was the occurrence of in-hospital events. Secondary endpoints included events during follow-up. Results Patients with coronary sclerosis were significantly older (70 ± 12 vs. 58 ± 16 years, p