title: Characteristics and management of patients with acute coronary syndrome and normal or non-significant coronary artery disease: results from Acute Coronary Syndrome Israeli Survey (ACSIS) 2004-2010.
abstract: BACKGROUND
  An important subset of patients presenting with acute coronary syndrome (ACS) are found to have either normal coronaries (NCs) or non-obstructive coronary artery disease (NOCAD; lumen diameter narrowing <50%).
  
  
  OBJECTIVE
  To explore the characteristics and management strategies in this population in a real-world setting.
  
  
  METHODS
  The Acute Coronary Syndrome Israeli Survey (ACSIS) database was utilized to compare the characteristics and therapeutic approach for patients who underwent angiography for ACS and had either NC (n = 84; 2%), NOCAD (n = 79; 2%), or obstructive coronary artery disease (OCAD; n = 3523; 96%).
  
  
  RESULTS
  Baseline characteristics were comparable, save for a younger age and a higher proportion of females in the NC group (P<.001 for both). Prior to admission, chronic anticoagulant therapy was more frequently used in the NC vs. the OCAD group (4.8% vs. 1.6%, respectively; P=.02). Recommended ACS evidence-based medications, both in-hospital and at discharge, were less frequently prescribed to patients with NC or NOCAD.
  
  
  CONCLUSIONS
  In a real-world practice of ACS, underutilization of evidence-based medications in patients with NC or NOCAD was observed. Nonetheless, its prognostic significance is still unknown and must be explored in larger patient cohorts.
authors.affiliation: MedStar Washington Hospital Center, 110 Irving St, NW, Suite 4B, Washington, DC 20010 USA. minha.saar@gmail.com.
authors.forename: Sa'ar
authors.initials: S
authors.lastname: Minha
authors.forename: Shmuel
authors.initials: S
authors.lastname: Gottlieb
authors.forename: Marco A
authors.initials: MA
authors.lastname: Magalhaes
authors.forename: Natalie
authors.initials: N
authors.lastname: Gavrielov-Yusim
authors.forename: Rikardo
authors.initials: R
authors.lastname: Krakover
authors.forename: Ilan
authors.initials: I
authors.lastname: Goldenberg
authors.forename: Zvi
authors.initials: Z
authors.lastname: Vered
authors.forename: Alex
authors.initials: A
authors.lastname: Blatt
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D000367:Age Factors; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D019468:Disease Management; D005260:Female; D006306:Health Surveys; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors