Clinical presentation and 3-year outcomes of patients with acute coronary syndromes and non-obstructive coronary arteries on angiography

Background With the emerging interest in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), there is a need to define an even broader group of patients with the syndrome of myocardial ischemia with non-obstructive coronary arteries (INOCA). There are limited data on...

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Bibliographic Details
Published in:PloS one 2020-06, Vol.15 (6), p.e0234735-e0234735
Main Authors: Zandecki, Lukasz, Janion-Sadowska, Agnieszka, Kurzawski, Jacek, Piatek, Lukasz, Zabojszcz, Michal, Plens, Krzysztof, Siudak, Zbigniew, Sadowski, Marcin, den Uil, Corstiaan
Format: Article
Language:English
Subjects:
Acute coronary syndrome
Acute coronary syndromes
Angiography
Arteries
Biology and Life Sciences
Bypass
Cardiac arrest
Cardiology
Care and treatment
Cerebral blood flow
Cerebral infarction
Congestive heart failure
Control methods
Coronary angiography
Coronary artery
Coronary artery disease
Health risk assessment
Health risks
Heart attack
Heart attacks
Heart failure
Heart surgery
Ischemia
Lesions
Medical imaging
Medicine and Health Sciences
Mortality
Myocardial infarction
Myocardial ischemia
Observational studies
Patient outcomes
Patients
Prognosis
Research and Analysis Methods
Signs and symptoms
Surgery
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Summary:Background With the emerging interest in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), there is a need to define an even broader group of patients with the syndrome of myocardial ischemia with non-obstructive coronary arteries (INOCA). There are limited data on the clinical characteristics and prognoses of such patients who present with symptoms of acute coronary syndrome (ACS) and undergo urgent coronary angiography that reveals no significant lesions. The aim of this observational study was to compare patients with ACS INOCA and those with ACS with obstructive coronary artery disease (OCAD) both within unadjusted cohorts and with propensity score matched controls. Methods and results This observational study was based on the data from the Polish National Registry of Invasive Cardiology Procedures. Of 9744 patients included, 7624 had OCAD and 2120 had ACS INOCA. In unadjusted cohorts, the overall survival and incidence of major adverse cardiovascular events (MACE: death, cardiac arrest, myocardial infarction, stroke, and heart failure hospitalization) until 36 months were higher in patients with ACS OCAD. Following propensity matching, higher win ratios of death (p = 0.02), additional revascularizations by percutaneous coronary intervention or coronary artery bypass graft surgery (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0234735