CARDIOVASCULAR EVENT ASSESSMENT IN PATIENTS WITH NONOBSTRUCTIVE CORONARY ARTERY DISEASE UNDERGOING DUAL ANTIPLATELET...

The aim of our study was to learn the differences in baseline presentation between NObCAD and obstructive coronary artery disease (ObCAD) subjects, to compare the likelihood of several clinical outcomes and the rate of primary endpoints between this groups. Out study included 165 patients: 115 patients with NObCAD ACS, 50 - with ObCAD ACS. Inclusion criteria: age >18 year; Presence of any atherosclerotic stenosis greater than 20% but less than 50% in the left main coronary artery, and greater than 20% but less than 70% in any other major epicardial coronary artery. Рatients with NObCAD ACS were randomly assign in an 1:1 ratio in 2 group: Group A (n=55) received dual antiplatelet treatment with aspirin 100-160 mg once daily and clopidogrel 75 mg once daily for three months. Group B (n=60) received only aspirin 100-160 mg once daily for three months. 50 patients with ObCAD ACS entered in group C - controlled group, patients were treated according appropriate treatment guidelines. Clinical, demographic and treatment data were investigated. Demographic variables included age and gender. Comorbidities included smoking, diabetes, hyperlipidemia, hypertension, obesity, and prior history of heart disease (angina, heart failure, myocardial infarction, coronary artery bypass grafting, and percutaneous coronary intervention), renal and liver disease. ECG changes and initial laboratory data were recorded. Laboratory analyses: CBC, urine test, serum lipid profile, fasting blood glucose and HbA1C, creatinine and eGFR, liver enzymes were provided. All patients underwent coronary angiography. Data describing patient management included use of β-blockers, aspirin, ACE inhibitors or angiotensin receptor blockers, lipid-lowering agents. We categorized each patient by CAD extent. To accomplish this, we categorized each patient by CAD severity in a single, double, or triple-vessel distribution. Follow-up evaluations were performed at one, two and three months and 1 year. At these visits was assessed primary endpoints - MACE (Major adverse cardiac events): 1year hospitalization for Myocardial infarction or other cardiovascular causes after index angiography, cardiovascular death, revascularization, survival. We studied type and frequency of bleeding during treatment and follow up period. After data assessment we can tell, that the combination of clopidogrel and aspirin was not significantly more effective than aspirin alone in reducing the rate of myocardial infarction, but there was significant difference between groups regarding the CVD event rates, revascularization frequency and bleeding rate.