title: Baseline clinical characteristics and midterm prognosis of STE-ACS and NSTE-ACS patients with normal coronary arteries.
abstract: OBJECTIVE
  We sought to compare clinical profiles and midterm prognosis of patients with normal coronary arteries presenting with ST-elevation ACS (STE-ACS) versus non-ST-elevation ACS (nSTE-ACS).
  
  
  BACKGROUND
  There are limited data regarding ACS in patients with normal coronary arteries, and especially clinical differences between ST-ACS and nSTE-ACS patients have not been evaluated sufficiently.
  
  
  METHODS
  The study group comprised 190 patients (mean age: 53.2 years, 63.1% males, 63.6% STE-ACS) presenting with ACS and normal coronary angiograms. The participants were evaluated in terms of 42 clinical variables. MACE [cardiac death (CD) and hospitalization for angina (HA)] were the study end points.
  
  
  RESULTS
  STE-ACS in comparison to nSTE-ACS patients were younger (P < 0.01), were more frequently males (P < 0.01), had more often infection prior to ACS (P < 0.01), higher hsCRP on admission (P < 0.01), and greater infarct size, measured by maximal troponin I (P < 0.01). By multivariate analysis in this subgroup, predictors of outcome were hsCRP (P = 0.03) and raised troponin I (P = 0.02). nSTE-ACS in comparison to STE-ACS patients were more obese (BMI, P < 0.01), had higher LDL cholesterol (P < 0.01), fasting glucose (P = 0.03). LDL cholesterol (P = 0.02) and fasting glucose (P = 0.03) emerged as independent predictors of outcome in these patients. Mean follow-up period was 25.4 months. STE-ACS patients had twice fewer MACE rate than nSTE-ACS patients [(1-CD, 12-HA; 11%) vs (1-CD, 16-HA; 25%), respectively, log rank P < 0.01].
  
  
  CONCLUSIONS
  STE-ACS and nSTE-ACS patients with normal coronary arteriography have different clinical profiles. In nSTE-ACS patients more pronounced metabolic abnormalities were identified, while in STE-ACS patients inflammatory background was more significant.
authors.affiliation: Department of Coronary Artery Disease, Institute of Cardiology, Warsaw, Poland. l.mazurkiewicz@ikard.pl
authors.forename: Lukasz
authors.initials: L
authors.lastname: Mazurkiewicz
authors.forename: Zofia T
authors.initials: ZT
authors.lastname: Bilinska
authors.forename: Mariusz
authors.initials: M
authors.lastname: Kruk
authors.forename: Andrzej
authors.initials: A
authors.lastname: Ciszewski
authors.forename: Jacek
authors.initials: J
authors.lastname: Grzybowski
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.forename: Witold
authors.initials: W
authors.lastname: Ruzyllo
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002423:Cause of Death; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000502:physiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D012720:Severity of Illness Index; D012737:Sex Factors; D016019:Survival Analysis; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I