Clinical presentation and 3-year outcomes of patients with acute coronary syndromes and non-obstructive coronary arteries on angiography
Background With the emerging interest in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), there is a need to define an even broader group of patients with the syndrome of myocardial ischemia with non-obstructive coronary arteries (INOCA). There are limited data on...
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| creator | Zandecki, Lukasz Janion-Sadowska, Agnieszka Kurzawski, Jacek Piatek, Lukasz Zabojszcz, Michal Plens, Krzysztof Siudak, Zbigniew Sadowski, Marcin den Uil, Corstiaan |
| description | Background With the emerging interest in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), there is a need to define an even broader group of patients with the syndrome of myocardial ischemia with non-obstructive coronary arteries (INOCA). There are limited data on the clinical characteristics and prognoses of such patients who present with symptoms of acute coronary syndrome (ACS) and undergo urgent coronary angiography that reveals no significant lesions. The aim of this observational study was to compare patients with ACS INOCA and those with ACS with obstructive coronary artery disease (OCAD) both within unadjusted cohorts and with propensity score matched controls. Methods and results This observational study was based on the data from the Polish National Registry of Invasive Cardiology Procedures. Of 9744 patients included, 7624 had OCAD and 2120 had ACS INOCA. In unadjusted cohorts, the overall survival and incidence of major adverse cardiovascular events (MACE: death, cardiac arrest, myocardial infarction, stroke, and heart failure hospitalization) until 36 months were higher in patients with ACS OCAD. Following propensity matching, higher win ratios of death (p = 0.02), additional revascularizations by percutaneous coronary intervention or coronary artery bypass graft surgery (p |
| doi_str_mv | 10.1371/journal.pone.0234735 |
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There are limited data on the clinical characteristics and prognoses of such patients who present with symptoms of acute coronary syndrome (ACS) and undergo urgent coronary angiography that reveals no significant lesions. The aim of this observational study was to compare patients with ACS INOCA and those with ACS with obstructive coronary artery disease (OCAD) both within unadjusted cohorts and with propensity score matched controls. Methods and results This observational study was based on the data from the Polish National Registry of Invasive Cardiology Procedures. Of 9744 patients included, 7624 had OCAD and 2120 had ACS INOCA. In unadjusted cohorts, the overall survival and incidence of major adverse cardiovascular events (MACE: death, cardiac arrest, myocardial infarction, stroke, and heart failure hospitalization) until 36 months were higher in patients with ACS OCAD. Following propensity matching, higher win ratios of death (p = 0.02), additional revascularizations by percutaneous coronary intervention or coronary artery bypass graft surgery (p<0.001), and cardiac hospitalization (p<0.001) were observed in these patients. In contrast, the win ratios of myocardial infarction (p = 0.74), heart failure hospitalization (p = 0.86), and MACE (p = 0.07) were not significantly different between the groups. Conclusions The prognosis of patients with ACS INOCA was more favorable than that of patients with ACS OCAD; however, the differences diminished after adjustments for the initial clinical profiles. An ACS incident should not be judged as trivial even when cardiac markers remain stable and no significant lesions are found on angiography.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0234735</identifier><identifier>PMID: 32544195</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Acute coronary syndrome ; Acute coronary syndromes ; Angiography ; Arteries ; Biology and Life Sciences ; Bypass ; Cardiac arrest ; Cardiology ; Care and treatment ; Cerebral blood flow ; Cerebral infarction ; Congestive heart failure ; Control methods ; Coronary angiography ; Coronary artery ; Coronary artery disease ; Health risk assessment ; Health risks ; Heart attack ; Heart attacks ; Heart failure ; Heart surgery ; Ischemia ; Lesions ; Medical imaging ; Medicine and Health Sciences ; Mortality ; Myocardial infarction ; Myocardial ischemia ; Observational studies ; Patient outcomes ; Patients ; Prognosis ; Research and Analysis Methods ; Signs and symptoms ; Surgery</subject><ispartof>PloS one, 2020-06, Vol.15 (6), p.e0234735-e0234735</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Zandecki et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Zandecki et al 2020 Zandecki et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c669t-ad427661a1ba54680fc066da90b7eb1863ee45aafd09c2906499401fc78aded63</citedby><cites>FETCH-LOGICAL-c669t-ad427661a1ba54680fc066da90b7eb1863ee45aafd09c2906499401fc78aded63</cites><orcidid>0000-0002-5913-3815 ; 0000-0002-9248-4510 ; 0000-0002-8530-434X ; 0000-0002-0495-2952</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297353/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7297353/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23849,27907,27908,53774,53776,79351,79352</link.rule.ids></links><search><contributor>den Uil, Corstiaan</contributor><creatorcontrib>Zandecki, Lukasz</creatorcontrib><creatorcontrib>Janion-Sadowska, Agnieszka</creatorcontrib><creatorcontrib>Kurzawski, Jacek</creatorcontrib><creatorcontrib>Piatek, Lukasz</creatorcontrib><creatorcontrib>Zabojszcz, Michal</creatorcontrib><creatorcontrib>Plens, Krzysztof</creatorcontrib><creatorcontrib>Siudak, Zbigniew</creatorcontrib><creatorcontrib>Sadowski, Marcin</creatorcontrib><creatorcontrib>den Uil, Corstiaan</creatorcontrib><title>Clinical presentation and 3-year outcomes of patients with acute coronary syndromes and non-obstructive coronary arteries on angiography</title><title>PloS one</title><description>Background With the emerging interest in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), there is a need to define an even broader group of patients with the syndrome of myocardial ischemia with non-obstructive coronary arteries (INOCA). There are limited data on the clinical characteristics and prognoses of such patients who present with symptoms of acute coronary syndrome (ACS) and undergo urgent coronary angiography that reveals no significant lesions. The aim of this observational study was to compare patients with ACS INOCA and those with ACS with obstructive coronary artery disease (OCAD) both within unadjusted cohorts and with propensity score matched controls. Methods and results This observational study was based on the data from the Polish National Registry of Invasive Cardiology Procedures. Of 9744 patients included, 7624 had OCAD and 2120 had ACS INOCA. In unadjusted cohorts, the overall survival and incidence of major adverse cardiovascular events (MACE: death, cardiac arrest, myocardial infarction, stroke, and heart failure hospitalization) until 36 months were higher in patients with ACS OCAD. Following propensity matching, higher win ratios of death (p = 0.02), additional revascularizations by percutaneous coronary intervention or coronary artery bypass graft surgery (p<0.001), and cardiac hospitalization (p<0.001) were observed in these patients. In contrast, the win ratios of myocardial infarction (p = 0.74), heart failure hospitalization (p = 0.86), and MACE (p = 0.07) were not significantly different between the groups. Conclusions The prognosis of patients with ACS INOCA was more favorable than that of patients with ACS OCAD; however, the differences diminished after adjustments for the initial clinical profiles. An ACS incident should not be judged as trivial even when cardiac markers remain stable and no significant lesions are found on angiography.</description><subject>Acute coronary syndrome</subject><subject>Acute coronary syndromes</subject><subject>Angiography</subject><subject>Arteries</subject><subject>Biology and Life Sciences</subject><subject>Bypass</subject><subject>Cardiac arrest</subject><subject>Cardiology</subject><subject>Care and treatment</subject><subject>Cerebral blood flow</subject><subject>Cerebral infarction</subject><subject>Congestive heart failure</subject><subject>Control methods</subject><subject>Coronary angiography</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Heart attack</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Heart surgery</subject><subject>Ischemia</subject><subject>Lesions</subject><subject>Medical imaging</subject><subject>Medicine and Health Sciences</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial ischemia</subject><subject>Observational studies</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Research and Analysis Methods</subject><subject>Signs and 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presentation and 3-year outcomes of patients with acute coronary syndromes and non-obstructive coronary arteries on angiography</title><author>Zandecki, Lukasz ; Janion-Sadowska, Agnieszka ; Kurzawski, Jacek ; Piatek, Lukasz ; Zabojszcz, Michal ; Plens, Krzysztof ; Siudak, Zbigniew ; Sadowski, Marcin ; den Uil, Corstiaan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c669t-ad427661a1ba54680fc066da90b7eb1863ee45aafd09c2906499401fc78aded63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acute coronary syndrome</topic><topic>Acute coronary syndromes</topic><topic>Angiography</topic><topic>Arteries</topic><topic>Biology and Life Sciences</topic><topic>Bypass</topic><topic>Cardiac arrest</topic><topic>Cardiology</topic><topic>Care and treatment</topic><topic>Cerebral blood flow</topic><topic>Cerebral infarction</topic><topic>Congestive heart failure</topic><topic>Control 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Krzysztof</au><au>Siudak, Zbigniew</au><au>Sadowski, Marcin</au><au>den Uil, Corstiaan</au><au>den Uil, Corstiaan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical presentation and 3-year outcomes of patients with acute coronary syndromes and non-obstructive coronary arteries on angiography</atitle><jtitle>PloS one</jtitle><date>2020-06-16</date><risdate>2020</risdate><volume>15</volume><issue>6</issue><spage>e0234735</spage><epage>e0234735</epage><pages>e0234735-e0234735</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Background With the emerging interest in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), there is a need to define an even broader group of patients with the syndrome of myocardial ischemia with non-obstructive coronary arteries (INOCA). There are limited data on the clinical characteristics and prognoses of such patients who present with symptoms of acute coronary syndrome (ACS) and undergo urgent coronary angiography that reveals no significant lesions. The aim of this observational study was to compare patients with ACS INOCA and those with ACS with obstructive coronary artery disease (OCAD) both within unadjusted cohorts and with propensity score matched controls. Methods and results This observational study was based on the data from the Polish National Registry of Invasive Cardiology Procedures. Of 9744 patients included, 7624 had OCAD and 2120 had ACS INOCA. In unadjusted cohorts, the overall survival and incidence of major adverse cardiovascular events (MACE: death, cardiac arrest, myocardial infarction, stroke, and heart failure hospitalization) until 36 months were higher in patients with ACS OCAD. Following propensity matching, higher win ratios of death (p = 0.02), additional revascularizations by percutaneous coronary intervention or coronary artery bypass graft surgery (p<0.001), and cardiac hospitalization (p<0.001) were observed in these patients. In contrast, the win ratios of myocardial infarction (p = 0.74), heart failure hospitalization (p = 0.86), and MACE (p = 0.07) were not significantly different between the groups. Conclusions The prognosis of patients with ACS INOCA was more favorable than that of patients with ACS OCAD; however, the differences diminished after adjustments for the initial clinical profiles. An ACS incident should not be judged as trivial even when cardiac markers remain stable and no significant lesions are found on angiography.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32544195</pmid><doi>10.1371/journal.pone.0234735</doi><tpages>e0234735</tpages><orcidid>https://orcid.org/0000-0002-5913-3815</orcidid><orcidid>https://orcid.org/0000-0002-9248-4510</orcidid><orcidid>https://orcid.org/0000-0002-8530-434X</orcidid><orcidid>https://orcid.org/0000-0002-0495-2952</orcidid><oa>free_for_read</oa></addata></record> |
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| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acute coronary syndrome Acute coronary syndromes Angiography Arteries Biology and Life Sciences Bypass Cardiac arrest Cardiology Care and treatment Cerebral blood flow Cerebral infarction Congestive heart failure Control methods Coronary angiography Coronary artery Coronary artery disease Health risk assessment Health risks Heart attack Heart attacks Heart failure Heart surgery Ischemia Lesions Medical imaging Medicine and Health Sciences Mortality Myocardial infarction Myocardial ischemia Observational studies Patient outcomes Patients Prognosis Research and Analysis Methods Signs and symptoms Surgery |
| title | Clinical presentation and 3-year outcomes of patients with acute coronary syndromes and non-obstructive coronary arteries on angiography |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-17T01%3A34%3A23IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Clinical%20presentation%20and%203-year%20outcomes%20of%20patients%20with%20acute%20coronary%20syndromes%20and%20non-obstructive%20coronary%20arteries%20on%20angiography&rft.jtitle=PloS%20one&rft.au=Zandecki,%20Lukasz&rft.date=2020-06-16&rft.volume=15&rft.issue=6&rft.spage=e0234735&rft.epage=e0234735&rft.pages=e0234735-e0234735&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0234735&rft_dat=%3Cgale_plos_%3EA626791058%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2413949535&rft_id=info:pmid/32544195&rft_galeid=A626791058&rft_doaj_id=oai_doaj_org_article_f557fb9a0d0d4f8c956a25b45dbe7659&rfr_iscdi=true |