Related Experiment Video

Updated: Nov 7, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.5K

Prognostic Implication of Non-Obstructive Coronary Lesions: A New Classification in Different Settings

Jorge Rodríguez-Capitán1, Andrés Sánchez-Pérez1, Sara Ballesteros-Pradas2

  • 1Área del Corazón, UMA Campus de Teatinos S/N, Hospital Universitario Virgen de la Victoria, CIBERCV, IBIMA, 29010 Málaga, Spain.

Journal of Clinical Medicine
|April 30, 2021
PubMed

Insights

Non-obstructive coronary artery disease indicates a worse long-term cardiovascular prognosis. This finding is particularly significant for non-diabetics, women, and patients with acute coronary syndrome.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Epidemiology

Background:

  • The clinical significance of non-obstructive coronary artery disease (CAD) remains debated.
  • Evaluating long-term cardiovascular outcomes in this patient group is crucial for risk stratification and management.
  • Existing research often focuses on obstructive CAD, leaving a gap in understanding non-obstructive disease prognosis.

Purpose of the Study:

  • To assess the long-term cardiovascular prognosis of patients with non-obstructive CAD.
  • To stratify prognosis based on sex, diabetes status, and clinical indication for coronary angiography.
  • To compare outcomes between normal coronary arteries, non-obstructive CAD (20-50% stenosis), and obstructive CAD (>70% stenosis).

Main Methods:

  • Multi-center retrospective longitudinal observational study.
  • Inclusion of 3265 patients undergoing coronary angiography.
  • Follow-up of combined cardiovascular events (myocardial infarction, stroke, heart failure hospitalization, cardiovascular death) over a mean of 43 months.

Main Results:

  • Non-obstructive CAD was associated with a significantly worse long-term cardiovascular prognosis compared to normal coronary arteries (HR 1.72).
  • This increased risk was pronounced in non-diabetic patients (HR 2.12), women (HR 1.75), and those with a history of acute coronary syndrome (HR 2.07).
  • A clear trend of worsening prognosis with increasing coronary artery stenosis severity was observed (p for trend <0.001).

Conclusions:

  • Non-obstructive coronary artery disease is linked to an impaired long-term cardiovascular prognosis.
  • The adverse association is particularly evident in specific subgroups: non-diabetics, women, and post-acute coronary syndrome patients.
  • These findings underscore the importance of considering non-obstructive CAD as a significant risk factor for future cardiovascular events.

Keywords:
acute coronary syndromecoronary angiographycoronary artery diseasediabetes mellitussex

More Related Videos

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty10:03

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty

Published on: January 28, 2020

5.5K
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.5K

Related Concept Videos

Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
90
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
108
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
108
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
67
Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
116
Coronary Artery Disease II: Pathophysiology01:26

Coronary Artery Disease II: Pathophysiology

Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
148