title: Is Myocardial Infarction in Patients without Significant Stenosis on a Coronary Angiogram as Benign as Believed?
abstract: The present study aimed to investigate the clinical characteristics and 1-year outcomes of acute myocardial infarction (AMI) patients without significant stenosis on a coronary angiogram comparison with the clinical characteristics and outcomes of patients with significant coronary artery stenosis. A total of 1,220 patients with AMI were retrospectively classified into Group I (≥50% diameter stenosis, n=1,120) and Group II (<50%, n=100). Group II was further divided into two subgroups according to the underlying etiology: cryptogenic (Group II-a, n=54) and those with possible causative factors (Group II-b, n=46). Patients in Group II were younger, were more likely to be women, and were less likely to smoke and to have diabetes mellitus than were patients in Group I. The levels of cardiac enzymes, LDL-cholesterol levels, and the apo-B/A1 ratio were lower in Group II. However, 1-month and 12-month rates of major adverse cardiac events (MACE) were not significantly different between the two groups. The Group II-b subgroup comprised 29 patients with vasospasm, 11 with myocardial bridge, and 6 with spontaneous thrombolysis. Left ventricular ejection fraction and creatinine clearance were lower and levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) were higher in Group II-a than in Group II-b. However, outcomes including MACE and mortality at 12 months were not significantly different between the two subgroups. The 1-year outcomes of patients in Group II were similar to those of patients in Group I. The clinical outcomes in Group II-a were also similar to those of Group II-b, although the former group showed higher levels of NT-proBNP and hs-CRP.
authors.affiliation: Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Shi Hyun
authors.initials: SH
authors.lastname: Rhew
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Kim
authors.forename: Su Young
authors.initials: SY
authors.lastname: Jang
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Cho
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Hwang
authors.forename: Min Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Jum Suk
authors.initials: JS
authors.lastname: Ko
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang