Patients with Non-Obstructive Coronary Artery Disease Require Strict Control of All Cardiovascular Risk Factors: Results from the Polish Local Population Medical Records

• Published in: Journal of clinical medicine 2021-06, Vol.10 (12), p.2704
• Main Authors: Hiczkiewicz, Jarosław, Burchardt, Paweł, Budzianowski, Jan, Pieszko, Konrad, Hiczkiewicz, Dariusz, Musielak, Bogdan, Winnicka-Zielińska, Anna, Keller, Daria M., Faron, Wojciech, Rzeźniczak, Janusz
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Angioplasty; Bioethics; Cardiology; Cardiovascular disease; Clinical medicine; Coronary vessels; Diabetes; Heart attacks; Heart failure; Hospitalization; Laboratories; Medical imaging; Risk factors; Statistical analysis; Stents; Survival analysis; Variance analysis
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm10122704

The aim of the project was to compare patients treated with percutaneous transluminal coronary angioplasty (PTCA), who also had undergone PTCA in the past, with a group of people who had had no angiographic stenosis in the lumen of the coronary arteries in the past, and who also required PTCA during index hospitalization. The secondary aim was to compare the obtained data with the characteristics of a group of people who had undergone angiography twice and for whom no significant stenosis had been found in their coronary arteries. The study used registry data concerning 3085 people who had undergone at least two invasive procedures. Acute coronary syndrome (ACS) was significantly more often observed (Non-ST-segment elevation myocardial infarction (NSTEMI) OR 2.76 [1.91–3.99] and ST-segment elevation myocardial infarction (STEMI) OR 2.35 [1.85–2.99]) in patients with no significant coronary stenosis in the past (who required coronary angioplasty at the time of the study), compared to patients who had already had PTCA. They also demonstrated more frequent occurrence of ‘multivessel disease’. This was probably most likely caused by inadequate control of cardiovascular risk factors, as determined by higher total cholesterol levels ([mg/dL] 193.7 ± 44.4 vs. 178.2 ± 43.7) and LDL (123.4 ± 36.2 vs. 117.7 ± 36.2). On the other hand, patients in whom no significant stenosis was found in two consecutive angiographies were more likely to be burdened with chronic obstructive pulmonary disease, atrial fibrillation and chronic kidney disease.