Non-Obstructive Coronaries In Patients Presenting With The Non St-Elevation Acute Coronary Syndrome

Area of Science:

• Cardiology
• Vascular Medicine
• Diagnostic Imaging

Background:

• Cardiovascular diseases are a leading cause of mortality globally.
• Acute coronary syndrome (ACS) is a common manifestation, with non-ST elevation ACS (NSTE-ACS) accounting for 70% of cases.
• NSTE-ACS often involves partial or intermittent coronary artery occlusion, necessitating investigation into non-obstructive causes.

Purpose of the Study:

• To determine the prevalence and characteristics of non-obstructive coronary arteries in patients with NSTE-ACS.
• To investigate the demographic and clinical factors associated with non-obstructive coronary arteries in this patient cohort.
• To contribute to understanding NSTE-ACS in a Pakistani population.

Main Methods:

• A descriptive cross-sectional study was conducted at a tertiary care cardiac center.
• Included were 174 patients aged 30-70 years admitted with NSTE-ACS.
• Coronary angiography was used to identify non-obstructive coronary arteries (absence of ≥50% stenosis).

Main Results:

• The study included 174 patients (56.9% male, mean age 59.43±11.24 years).
• Prevalent comorbidities included hypertension (43.7%), hyperlipidemia (31.6%), and chronic kidney disease (11.5%).
• Non-obstructive coronary arteries were identified in 25 patients (14.4%).

Conclusions:

• Non-obstructive coronary arteries are a significant finding in patients presenting with NSTE-ACS in this population.
• The prevalence of 14.4% underscores the importance of considering non-obstructive causes in NSTE-ACS.
• Further research is recommended to elucidate pathophysiology and optimize management for non-obstructive coronary artery disease (NOCA) in NSTE-ACS.