Prognostic Implication of Non-Obstructive Coronary Lesions: A New Classification in Different Settings
| Autor: | Mario Gutiérrez-Bedmar, Manuel Oneto-Fernández, Sara Ballesteros-Pradas, Rosa Cardenal-Piris, Lola Gutiérrez-Alonso, Andrés Sánchez-Pérez, Mercedes Millán-Gómez, Macarena Cano-García, Jorge Rodriguez-Capitan, Agustín Guisado-Rasco, Ricardo Rivera-López, Manuel F. Jiménez-Navarro |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome 030204 cardiovascular system & hematology Article acute coronary syndrome Coronary artery disease 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus medicine sex 030212 general & internal medicine Myocardial infarction Stroke business.industry Hazard ratio General Medicine medicine.disease Confidence interval Heart failure diabetes mellitus Cardiology Medicine coronary angiography business coronary artery disease |
| Zdroj: | Journal of Clinical Medicine, Vol 10, Iss 1863, p 1863 (2021) Journal of Clinical Medicine Volume 10 Issue 9 |
| ISSN: | 2077-0383 |
| Popis: | The clinical significance of non-obstructive coronary artery disease is the subject of debate. Our objective was to evaluate the long-term cardiovascular prognosis associated with non-obstructive coronary artery disease in patients undergoing coronary angiography, and to conduct a stratification by sex, diabetes, and clinical indication. We designed a multi-centre retrospective longitudinal observational study of 3265 patients that were classified into three groups: normal coronary arteries (lesion < 20%, 1426 patients), non-obstructive coronary artery disease (20–50%, 643 patients), and obstructive coronary artery disease (> 70%, 1196 patients). During a mean follow-up of 43 months, we evaluated a combined cardiovascular event: acute myocardial infarction, stroke, hospitalization for heart failure, or cardiovascular death. Multivariable-adjusted Cox proportional hazard models showed a worse prognosis in patients with non-obstructive coronary artery disease, in comparison with patients of normal coronary arteries group, in the total population (hazard ratio 1.72, 95% confidence interval 1.23–2.39 p for trend < 0.001), in non-diabetics (hazard ratio 2.12, 95% confidence interval: 1.40–3.22), in women (hazard ratio 1.75, 95% confidence interval 1.10–2.77), and after acute coronary syndrome (hazard ratio 2.07, 95% confidence interval 1.25–3.44). In conclusion, non-obstructive coronary artery disease is associated with an impaired long-term cardiovascular prognosis. This association held for non-diabetics, women, and after acute coronary syndrome. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|