[Clinical characteristics, epidemiology and prognosis of acute coronary syndrome without ST-segment elevation and angiographically normal coronary arteries].
OBJECTIVE
It has been estimated that up to 12% of patients with acute myocardial infarction do not present coronary atherosclerotic disease demonstrable with angiographic studies. We assessed the clinical characteristics and prognosis of acute coronary syndrome without ST-segment elevation with angiographically normal coronary arteries.


METHODS
Comparative retrospective analysis of 58 consecutive patients with this diagnosis and a sample (n = 59) with lesions in angiographic studies, analyzing demographic characteristics, analytical parameters, electrocardiogram, ventricular function and prognosis.


RESULTS
The group represented 19% of the totality of acute coronary syndromes, showing a lower prevalence rates of hypercholesterolemia, diabetes mellitus and no record of ischemic heart disease (p = 0.043 to p = 0.005). The presence of regional wall motion abnormalities was significantly higher in the group with angiographic lesions (76.3% vs 41.4%; p < 0.01). In-hospital mortality rate showed a non significant trend toward to be lower in the group with normal angiogram (1.7% vs 8.4%).


CONCLUSIONS
The absence of significant coronary artery disease in acute coronary syndrome without ST-segment elevation is not infrequent and was related to a lower cardiovascular risk profile and the absence of regional wall motion abnormalities showing a trend toward better in-hospital prognosis.
Navas Lobato
Miguel Angel
MA
Servicio de Cardiología. Hospital Universitario La Paz. Madrid. España. mnavaslo@hotmail.com
Martín Reyes
Roberto
R
Peinado Peinado
Rafael
R
Lurueña Lobo
Pilar
P
Roldán Rabadán
Inmaculada
I
López Sendón
José Luis
JL
D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000175:diagnosis; D016001:Confidence Intervals; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors