Long-term survival and causes of death in patients with ST-elevation acute coronary syndrome without obstructive
Hedvig Bille Andersson1,2,3, Frants Pedersen1, Thomas Engstrøm1
1Department of Cardiology, The Heart Centre, Rigshospitalet, Copenhagen University Hospital, 2100 Blegdamsvej 9, Copenhagen, Denmark.
European Heart Journal
|October 14, 2017
Summary
Patients with ST-elevation acute coronary syndrome (STE-ACS) but no obstructive coronary artery disease (CAD) face a long-term mortality risk similar to or higher than those with obstructive CAD. These patients require close medical attention and follow-up.
Area of Science:
- Cardiology
- Clinical Medicine
- Public Health
Background:
- ST-elevation acute coronary syndrome (STE-ACS) is a critical condition often associated with obstructive coronary artery disease (CAD).
- However, a subset of patients present with STE-ACS without significant coronary artery blockages, necessitating further investigation into their prognosis.
Purpose of the Study:
- To investigate and compare the long-term survival rates and causes of death in patients diagnosed with STE-ACS, stratified by the presence or absence of obstructive CAD.
- To evaluate the clinical implications for managing STE-ACS patients without obstructive CAD.
Main Methods:
- A cohort of 4793 consecutive patients with STE-ACS undergoing acute coronary angiography between 2009 and 2014 was analyzed.
- Patients were categorized into obstructive CAD (stenosis ≥50%), non-obstructive CAD (stenosis 1-49%), and normal coronary arteries groups.
- Survival and causes of death were assessed over a median follow-up of 2.6 years.
Main Results:
- Patients without obstructive CAD were younger, more often female, and had fewer cardiovascular risk factors.
- Short-term mortality (≤30 days) was lower in patients without obstructive CAD compared to those with obstructive CAD.
- Long-term mortality (>30 days) was similar in non-obstructive CAD and higher in normal coronary arteries groups compared to obstructive CAD. Cardiovascular causes of death were less frequent in patients without obstructive CAD.
Conclusions:
- STE-ACS patients without obstructive CAD exhibit a long-term mortality risk comparable to or exceeding that of patients with obstructive CAD.
- The causes of death in this subgroup are less frequently cardiovascular, suggesting different underlying pathologies.
- These findings underscore the need for diligent medical attention and close follow-up for STE-ACS patients presenting without obstructive CAD.
Keywords:
Causes of deathNon-obstructive coronary artery diseaseST-elevation acute coronary syndromeST-elevation myocardial infarctionSurvivalMore Related Videos
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