Are patients with angiographically near-normal coronary arteries who present as acute myocardial infarction actually safe?
BACKGROUND
There is a paucity of data concerning the clinical outcome of patients presenting with acute myocardial infarction (AMI) and near-normal coronary angiograms. The purpose of this study was to evaluate the clinical outcome and the prognosis of the patients with near-normal coronary angiograms who were registered in the Korean Acute Myocardial Infarction Registry (KAMIR).


METHODS
The subjects were divided into three groups according to findings from coronary angiograms performed between September 2005 and November 2006. Among 8510 consecutive AMI patients, 372 patients (Group I) had near-normal coronary arteries, 6136 patients (Group II) had one- or two-vessel disease, and 2002 patients (Group III) had three-vessel or left main disease.


RESULTS
Clinical characteristics, in-hospital mortality, and major cardiac adverse events (MACE) were analyzed. Group I was younger, had the lower prevalence of DM, and showed the higher percentage of previous angina history compared to the other two groups. Group III showed a higher incidence of in-hospital mortality, but there was no significant difference between Group I and Group II (2.6% in Group II and 2.2% in Group I, p=0.952). Furthermore, MACE at 1 month, 6 months and 12 months revealed no significant difference between Groups I and II (12 month MACE: 7.8% in Group I and 12.2% in Group II, p=0.359).


CONCLUSIONS
Patients with near-normal coronary angiograms had similar clinical outcomes and prognosis compared with one- or two-vessel diseased patients presenting with an acute myocardial infarction.
Kang
Won Yu
WY
Chonnam National University, Gwangju, South Korea.
Jeong
Myung Ho
MH
Ahn
Young Keun
YK
Kim
Jong Hyun
JH
Chae
Shung Chull
SC
Kim
Young Jo
YJ
Hur
Seung Ho
SH
Seong
In Whan
IW
Hong
Taek Jong
TJ
Choi
Dong Hoon
DH
Cho
Myeong Chan
MC
Kim
Chong Jin
CJ
Seung
Ki Bae
KB
Chung
Wook Sung
WS
Jang
Yang Soo
YS
Rha
Seung Woon
SW
Bae
Jang Ho
JH
Cho
Jeong Gwan
JG
Park
Seung Jung
SJ
D000368:Aged; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D003325:Coronary Care Units / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data; D012720:Severity of Illness Index