Three-year follow-up in patients with acute coronary syndrome and normal coronary angiography.

OBJECTIVE

The present study was conducted to compare the clinical outcomes and investigate prognostic factors of acute coronary syndrome (ACS) in patients with normal coronary angiography.

METHODS

The study was a retrospective cohort of 736 adult patients admitted with ACS between April 2007 and March 2008. After 3 years of follow-up, data regarding the following endpoints were obtained: death (cardiac and noncardiac), nonfatal myocardial infarction, and recurrent angina leading to repeated coronary angiography. The analysis focused on patients with a culprit lesion (n=678) and on those without a culprit lesion (n=51).

RESULTS

Major adverse cardiac events (MACEs) were significantly more frequent in the group with culprit lesions than in the group without culprit lesions (P<0.05). The frequency of MACE-free survival was significantly lower in the group with culprit lesions than in the group without culprit lesions (P=0.0016). Diabetes mellitus was a significant independent predictor of poor prognosis.

CONCLUSION

ACS patients without culprit lesions have an excellent prognosis for MACE after 3 years of follow-up compared with patients with obstructive ACS. Diabetes mellitus predicts adverse outcome in ACS patients.