Follow-up of patients with myocardial ischemia without obstructive coronary lesions
Ana Liuvys Cuba Rodríguez1, Lázaro Isralys Aldama Pérez2, Myder Hernández Navas3
1Centro de Investigaciones Médico-Quirúrgicas (CIMEQ), La Habana, Cuba. Centro de Investigaciones Médico Quirúrgicas Centro de Investigaciones Médico-Quirúrgicas (CIMEQ) La Habana Cuba.
Insights
Patients with myocardial ischaemia but no obstructive coronary lesions face adverse cardiovascular events. Risk factors like diabetes and kidney disease increase this likelihood, impacting long-term outcomes.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Myocardial ischaemia with non-obstructive coronary arteries is a frequent clinical finding.
- Understanding the long-term prognosis in these patients is crucial for effective management.
Purpose of the Study:
- To investigate the clinical course and outcomes of patients diagnosed with myocardial ischaemia but lacking obstructive coronary lesions.
Main Methods:
- A prospective analytical study involving 110 patients with myocardial ischaemia and coronary lesions <50%.
- Follow-up duration was three years.
Main Results:
- 80% of patients remained free of cardiovascular events over three years.
- Hypertension and dyslipidaemia were common risk factors.
- Diabetes mellitus, family history of ischaemic heart disease, and chronic kidney disease were associated with higher cardiovascular event rates.
Conclusions:
- Patients with myocardial ischaemia and non-obstructive coronary lesions can experience adverse events.
- Specific comorbidities significantly increase the risk of adverse cardiovascular outcomes in this population.
Objective:
The presence of coronary lesions of less than 50% in patients with myocardial ischaemia is a common diagnosis in cardiac catheterisation laboratories. The aim of this study was to determine the clinical course of patients with myocardial ischaemia in the absence of obstructive coronary lesions.
Materials And Methods:
A prospective analytical study was conducted in 110 patients of both sexes with documented myocardial ischaemia and coronary lesions of less than 50% on coronary angiography. The follow-up period was three years.
Results:
The mean age was 64.5 ± 7.2 years, with a predominance of females (57%). The most prevalent risk factors were hypertension (58.2%) and dyslipidaemia (44.5%). In 8.3% of cases, re-hospitalisation was required, with heart failure reported as the leading cause (6.5%). Cardiovascular event-free survival during follow-up was 80%, and was higher in patients without coronary lesions. A higher incidence of cardiovascular events was associated with diabetes mellitus, a family history of ischaemic heart disease, and chronic kidney disease.
Conclusions:
Patients with myocardial ischaemia in the absence of obstructive coronary lesions experienced adverse events during follow-up, particularly those with diabetes mellitus, a family history of ischaemic heart disease, and chronic kidney disease.
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