The Prognostic Implications of Non-Obstructive Coronary Artery Disease

Abstract

Non-obstructive coronary artery disease is a frequent finding in patients undergoing coronary angiography. Our aim was to assess potential coronary events in non-obstructive coronary artery disease patients. Methods: We conducted a historical prospective cohort trial that analyzed 429 patients with non-obstructive coronary artery disease and 424 control patients with normal coronaries. Baseline characteristics, as well as major cardiac events during follow-up (30±8 months), were compared. Results: non-obstructive coronary artery disease patients were older, had more diabetes, more hypertension, and more chronic renal failure. They also more often had a history of myocardial infarction and of heart failure. During follow-up, non-obstructive coronary artery disease was associated with higher rates of unstable angina, stroke, death, and a combined endpoint of unstable angina, stroke, myocardial infarction, or death. On multivariate analysis, the presence of non-obstructive coronary artery disease was independently associated with the combined adverse outcome. Conclusions: Non-obstructive coronary artery disease patients have a higher frequency of atherosclerotic risk factors, associated cardiovascular disorders, and adverse clinical events in comparison to normal coronary artery disease patients. Over mid-term follow-up, non-obstructive coronary artery disease is an independent predictor of risk for major cardiac events.