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Updated: Aug 20, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Myocardial infarction with normal coronary arteries: ten-year follow-up
Pier-Giorgio Golzio1, Fulvio Orzan, Paolo Ferrero
1Cardiology, Department of Internal Medicine, University of Turin, Turin, Italy. pgolzio@molinette.piemonte.it
Insights
Patients with myocardial infarction but no significant coronary artery lesions have varying prognoses. Vessel morphology predicts ischemic events, while ejection fraction predicts cardiac death, highlighting key prognostic factors.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Research
Background:
- Myocardial infarction (MI) patients without significant coronary artery lesions generally have better prognoses.
- However, varying degrees of coronary involvement may influence individual risk.
- Identifying prognostic factors in this patient group is crucial for risk stratification.
Purpose of the Study:
- To assess clinical and angiographic covariates for defining individual prognosis in MI patients with non-obstructive coronary lesions.
- To differentiate prognosis based on the degree of coronary artery narrowing (< or = 50%).
Main Methods:
- Prospective follow-up of 53 consecutive MI patients with culprit lesions causing < or = 50% luminal narrowing.
- Patients categorized into groups: normal angiograms (A), minor irregularities (B), or discrete stenosis (C).
- Median follow-up of 125 months, assessing survival, ischemic events, and cardiac death.
Main Results:
- Group A (normal) had higher ejection fraction and 100% 10-year survival vs. 77% (B) and 58% (C) (p=0.01).
- Ischemic events correlated with lesion severity and lower ejection fraction (p=0.003, p=0.006).
- Multivariate analysis identified vessel morphology as predictive of ischemic events (p=0.02) and ejection fraction as the sole predictor of death (p=0.0012).
Conclusions:
- MI patients with normal coronary vessels have a very low risk of ischemic events.
- Vessel morphology and ejection fraction are key independent predictors of prognosis in MI patients with non-significant coronary lesions.
- Depressed ventricular function strongly correlates with cardiac mortality.
Background:
Patients with myocardial infarction without angiographically significant coronary artery lesions are considered, as a whole, to have a better prognosis. Different degrees of coronary involvement, within this wide group, may portend different degrees of risk. The aim of this study was to assess which clinical and angiographic covariates are more useful in defining the individual prognosis. METHLODS: We prospectively followed 53 consecutive patients admitted to our coronary care unit between 1985-1990 with myocardial infarction and a culprit lesion causing < or = 50% angiographic luminal narrowing.
Results:
Patients with normal angiograms (group A) were compared to those with minor parietal irregularities (group B) or discrete (< or = 50%) stenosis (group C). Group A patients were younger, had a lower peak creatine kinase release, and a higher ejection fraction. After a median follow up of 125 +/- 32 months, group A patients had a 100% 10-year survival compared to 77 and 58% for group B and group C patients respectively (p = 0.01). At univariate analysis, ischemic events correlated with the severity of coronary lesions (while group A patients had no ischemic events at follow-up, events occurred in 46 and 50% of group B and C patients respectively; p = 0.003) and with ejection fraction, that was lower in patients with events (56.0 +/- 17 vs 67 +/- 11%, p = 0.006). Cardiac death, too, correlated with the type of coronary lesions (p = 0.03) and with lower ejection fraction (p = 0.004). By means of multivariate analysis, on the contrary, only the vessel morphology was predictive of ischemic events at follow-up (p = 0.02), while the only significant predictor of death was ejection fraction (p = 0.0012).
Conclusions:
Patients with myocardial infarction and strictly normal vessels have very few ischemic events at follow-up, and may be distinguished from both patients with non-significant lesions as well as those with minor angiographic irregularities. On the other hand, cardiac mortality correlates strongly and independently with a depressed ventricular function.
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