Alzuhairi KS, et al. - This study entailed an assessment of long-term prognosis of patients with non-ST-segment elevation myocardial infarction (NSTEMI) according to the degree of coronary artery disease (CAD) on coronary angiography (CAG). Findings demonstrated that prognosis of patients with NSTEMI and non-obstructive CAD (both normal coronaries and diffuse atherosclerosis) was comparable to that of patients with one- or two-vessel disease. In comparison to those with angiographically normal coronary arteries, patients with diffuse atherosclerosis had worse prognosis.

Methods

• This study included a total of 8.889 consecutive patients admitted for first time NSTEMI during 2000–2011, to whom CAG was performed.
• According to the degree of CAD on CAG, patients were categorized as: 0-vessel disease (0VD), diffuse atherosclerosis (DA) (0% < stenosis <50%), 1-vessel disease (1VD), 2VD, and 3VD with stenosis ≥50%.
• A follow-up was also performed for a period of 13 years (median 4.5).

Results

• Findings demonstrated that 1-year mortality for NSTEMI patients with 0VD was 3.7%, DA 5.7%, 1VD 2.5%, 2VD 4.8%, and 3VD 11.5%.
• Higher risk of mortality was reported among non-diabetic 0VD patients vs 1VD patients (HR:1.59; 95% CI:1.21–2.02; P < 0.001), while those with diabetes mellitus (DM) had not significantly different risk.
• Data reported that 0VD group vs 1VD had higher risk of heart failure (HF) (HR 1.61; 95% CI: 1.39–1.88; P < 0.001), and lower risk of recurrent MI (HR:0.55; 95% CI:0.39–0.77; P < 0.001).
• Researchers also observed that for patients with DA; mortality and HF risks were higher than 1VD and not different than 2VD, while recurrent MI risk was not different than 1VD and lower than 2VD.
• They also noted that the DA group had higher risk of mortality if they had DM, higher risk of recurrent MI, and not different risk of HF and stroke compared with the 0VD group patients.