Background: The characterization of patients who have acute coronary syndrome (ACS) with insignificant coronary stenosis is unclear.
Aim: The present study aimed to investigate the clinical profile, in-hospital and 3-months outcome of ACS patients with insignificant coronary stenosis on a coronary angiography.
Methods: This prospective observational study included 200 consecutive patients admitted with ACS. Group I (100 patients) included patients with insignificant CAD (all lesions <50% stenosis). Group II (100 patients) included patients with one or more lesions ? 70% stenosis. Patients with Previous CABG were excluded.
Results: Patients with insignificant CAD were significantly younger (61 vs. 67 years, p <0.001), more likely to be females (41% vs. 23%, p = 0.006), less likely to smoke (p = 0.006), less likely to have diabetes mellitus (p <0.001), and less likely to have history of CAD (p = 0.042 ) or prior PCI (p = 0.037). They were also less likely to have typical anginal pain at presentation (61% vs 91%, p<0.001), less likely to have heart failure at presentation (9% vs 30%, p<0.001), less likely to have ischemic ST-segment changes on presentation, (10% vs 46%, p <0.001), lower peak troponin (p <0.001) and CK-MB levels (p <0.001), with lower LDL-C (p = 0.006), and higher HDL-C level (p = 0.020). they were less likely to be treated with thienopyridines (p <0.001), statins (p<0.001), b-blockers (p = 0.002), ACEI/ARBS (p = 0.007), and higher rates of calcium channel blocker therapy (p <0.001). They had lower prevalence of major adverse clinical events at follow up (readmission for ACS (p = 0.009), revascularization (p = 0.035), recurrent chest pain (p = 0.009), cardiogenic shock (p = 0.029).
Conclusion: Patients with ACS and insignificant CAD have different clinical profile and outcome compared to those with significant disease.