Long-Term Clinical Impact of Patients with Multi-Vessel Non-Obstructive Coronary Artery Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Study Endpoint and Definition
2.3. Statistical Analyses
3. Results
3.1. Baseline Characteristics
3.2. Long-Term Clinical Outcomes
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Roth, G.A.; Mensah, G.A.; Johnson, C.O.; Addolorato, G.; Ammirati, E.; Baddour, L.M.; Barengo, N.C.; Beaton, A.Z.; Benjamin, E.J.; Benziger, C.P.; et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study. J. Am. Coll. Cardiol. 2020, 76, 2982–3021. [Google Scholar] [CrossRef]
- Yusuf, S.; Reddy, S.; Ounpuu, S.; Anand, S. Global burden of cardiovascular diseases: Part II: Variations in cardiovascular disease by specific ethnic groups and geographic regions and prevention strategies. Circulation 2001, 104, 2855–2864. [Google Scholar] [CrossRef]
- Knuuti, J.; Wijns, W.; Saraste, A.; Capodanno, D.; Barbato, E.; Funck-Brentano, C.; Prescott, E.; Storey, R.F.; Deaton, C.; Cuisset, T.; et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur. Heart J. 2020, 41, 407–477. [Google Scholar] [CrossRef]
- Gulati, M.; Levy, P.D.; Mukherjee, D.; Amsterdam, E.; Bhatt, D.L.; Birtcher, K.K.; Blankstein, R.; Boyd, J.; Bullock-Palmer, R.P.; Conejo, T.; et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021, 144, e368–e454. [Google Scholar]
- Kim, Y.K.; Jang, C.W.; Kwon, S.H.; Kim, J.H.; Lerman, A.; Bae, J.H. Ten-year clinical outcomes in patients with intermediate coronary stenosis according to the combined culprit lesion. Clin. Cardiol. 2021, 44, 1161–1168. [Google Scholar] [CrossRef]
- Olesen, K.K.W.; Madsen, M.; Lip, G.Y.H.; Egholm, G.; Thim, T.; Jensen, L.O.; Raungaard, B.; Nielsen, J.C.; Botker, H.E.; Sorensen, H.T.; et al. Coronary artery disease and risk of adverse cardiac events and stroke. Eur. J. Clin. Investig. 2017, 47, 819–828. [Google Scholar] [CrossRef]
- Kemp, H.G.; Kronmal, R.A.; Vlietstra, R.E.; Frye, R.L. Seven year survival of patients with normal or near normal coronary arteriograms: A CASS registry study. J. Am. Coll. Cardiol. 1986, 7, 479–483. [Google Scholar] [CrossRef]
- Patel, M.R.; Chen, A.Y.; Peterson, E.D.; Newby, L.K.; Pollack, C.V., Jr.; Brindis, R.G.; Gibson, C.M.; Kleiman, N.S.; Saucedo, J.F.; Bhatt, D.L.; et al. Prevalence, predictors, and outcomes of patients with non-ST-segment elevation myocardial infarction and insignificant coronary artery disease: Results from the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines (CRUSADE) initiative. Am. Heart J. 2006, 152, 641–647. [Google Scholar]
- Stergiopoulos, K.; Boden, W.E.; Hartigan, P.; Mobius-Winkler, S.; Hambrecht, R.; Hueb, W.; Hardison, R.M.; Abbott, J.D.; Brown, D.L. Percutaneous coronary intervention outcomes in patients with stable obstructive coronary artery disease and myocardial ischemia: A collaborative meta-analysis of contemporary randomized clinical trials. JAMA Intern. Med. 2014, 174, 232–240. [Google Scholar] [CrossRef]
- Sorajja, P.; Gersh, B.J.; Cox, D.A.; McLaughlin, M.G.; Zimetbaum, P.; Costantini, C.; Stuckey, T.; Tcheng, J.E.; Mehran, R.; Lansky, A.J.; et al. Impact of multivessel disease on reperfusion success and clinical outcomes in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction. Eur. Heart J. 2007, 28, 1709–1716. [Google Scholar] [CrossRef]
- Mach, F.; Baigent, C.; Catapano, A.L.; Koskinas, K.C.; Casula, M.; Badimon, L.; Chapman, M.J.; De Backer, G.G.; Delgado, V.; Ference, B.A.; et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Eur. Heart J. 2020, 41, 111–188. [Google Scholar] [CrossRef]
- Valgimigli, M.; Bueno, H.; Byrne, R.A.; Collet, J.P.; Costa, F.; Jeppsson, A.; Juni, P.; Kastrati, A.; Kolh, P.; Mauri, L.; et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur. Heart J. 2018, 39, 213–260. [Google Scholar]
- Ambrose, J.A.; Tannenbaum, M.A.; Alexopoulos, D.; Hjemdahl-Monsen, C.E.; Leavy, J.; Weiss, M.; Borrico, S.; Gorlin, R.; Fuster, V. Angiographic progression of coronary artery disease and the development of myocardial infarction. J. Am. Coll. Cardiol. 1988, 12, 56–62. [Google Scholar] [CrossRef]
- Maddox, T.M.; Stanislawski, M.A.; Grunwald, G.K.; Bradley, S.M.; Ho, P.M.; Tsai, T.T.; Patel, M.R.; Sandhu, A.; Valle, J.; Magid, D.J.; et al. Nonobstructive coronary artery disease and risk of myocardial infarction. JAMA 2014, 312, 1754–1763. [Google Scholar] [CrossRef]
- Mortensen, M.B.; Dzaye, O.; Steffensen, F.H.; Botker, H.E.; Jensen, J.M.; Ronnow Sand, N.P.; Kragholm, K.H.; Sorensen, H.T.; Leipsic, J.; Maeng, M.; et al. Impact of Plaque Burden Versus Stenosis on Ischemic Events in Patients With Coronary Atherosclerosis. J. Am. Coll. Cardiol. 2020, 76, 2803–2813. [Google Scholar] [CrossRef]
- Levine, G.N.; Bates, E.R.; Blankenship, J.C.; Bailey, S.R.; Bittl, J.A.; Cercek, B.; Chambers, C.E.; Ellis, S.G.; Guyton, R.A.; Hollenberg, S.M.; et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J. Am. Coll. Cardiol. 2011, 58, e44–e122. [Google Scholar] [CrossRef]
- Redfors, B.; Furer, A.; Selker, H.P.; Thiele, H.; Patel, M.R.; Chen, S.; Udelson, J.E.; Ohman, E.M.; Eitel, I.; Granger, C.B.; et al. Effect of Smoking on Outcomes of Primary PCI in Patients With STEMI. J. Am. Coll. Cardiol. 2020, 75, 1743–1754. [Google Scholar] [CrossRef]
- Matsuo, S.; Imai, E.; Horio, M.; Yasuda, Y.; Tomita, K.; Nitta, K.; Yamagata, K.; Tomino, Y.; Yokoyama, H.; Hishida, A.; et al. Revised equations for estimated GFR from serum creatinine in Japan. Am. J. Kidney Dis. 2009, 53, 982–992. [Google Scholar] [CrossRef]
- Nakazato, R.; Arsanjani, R.; Achenbach, S.; Gransar, H.; Cheng, V.Y.; Dunning, A.; Lin, F.Y.; Al-Mallah, M.; Budoff, M.J.; Callister, T.Q.; et al. Age-related risk of major adverse cardiac event risk and coronary artery disease extent and severity by coronary CT angiography: Results from 15 187 patients from the International Multisite CONFIRM Study. Eur. Heart J. Cardiovasc. Imaging 2014, 15, 586–594. [Google Scholar] [CrossRef]
- Rodriguez-Capitan, J.; Sanchez-Perez, A.; Ballesteros-Pradas, S.; Millan-Gomez, M.; Cardenal-Piris, R.; Oneto-Fernandez, M.; Gutierrez-Alonso, L.; Rivera-Lopez, R.; Guisado-Rasco, A.; Cano-Garcia, M.; et al. Prognostic Implication of Non-Obstructive Coronary Lesions: A New Classification in Different Settings. J. Clin. Med. 2021, 10, 1863. [Google Scholar] [CrossRef]
- Little, W.C.; Constantinescu, M.; Applegate, R.J.; Kutcher, M.A.; Burrows, M.T.; Kahl, F.R.; Santamore, W.P. Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? Circulation 1988, 78, 1157–1166. [Google Scholar] [CrossRef] [PubMed]
- Bittencourt, M.S.; Hulten, E.; Ghoshhajra, B.; O’Leary, D.; Christman, M.P.; Montana, P.; Truong, Q.A.; Steigner, M.; Murthy, V.L.; Rybicki, F.J.; et al. Prognostic value of nonobstructive and obstructive coronary artery disease detected by coronary computed tomography angiography to identify cardiovascular events. Circ. Cardiovasc. Imaging 2014, 7, 282–291. [Google Scholar] [CrossRef] [PubMed]
- Chow, B.J.; Small, G.; Yam, Y.; Chen, L.; McPherson, R.; Achenbach, S.; Al-Mallah, M.; Berman, D.S.; Budoff, M.J.; Cademartiri, F.; et al. Prognostic and therapeutic implications of statin and aspirin therapy in individuals with nonobstructive coronary artery disease: Results from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter registry) registry. Arterioscler. Thromb. Vasc. Biol. 2015, 35, 981–989. [Google Scholar] [PubMed]
- Jamee, A.; Abed, Y.; Jalambo, M.O. Gender difference and characteristics attributed to coronary artery disease in Gaza-Palestine. Glob. J. Health Sci. 2013, 5, 51–56. [Google Scholar] [CrossRef]
- Kissel, C.K.; Chen, G.; Southern, D.A.; Galbraith, P.D.; Anderson, T.J.; For the APPROACH investigators. Impact of clinical presentation and presence of coronary sclerosis on long-term outcome of patients with non-obstructive coronary artery disease. BMC Cardiovasc. Disord. 2018, 18, 173. [Google Scholar] [CrossRef]
- Zhang, H.W.; Jin, J.L.; Cao, Y.X.; Guo, Y.L.; Wu, N.Q.; Zhu, C.G.; Xu, R.X.; Dong, Q.; Li, J.J. Association of diabetes mellitus with clinical outcomes in patients with different coronary artery stenosis. Cardiovasc. Diabetol. 2021, 20, 214. [Google Scholar] [CrossRef]
- Berge, C.A.; Eskerud, I.; Almeland, E.B.; Larsen, T.H.; Pedersen, E.R.; Rotevatn, S.; Lonnebakken, M.T. Relationship between hypertension and non-obstructive coronary artery disease in chronic coronary syndrome (the NORIC registry). PLoS ONE 2022, 17, e0262290. [Google Scholar] [CrossRef]
- Wang, H.; Ning, X.; Zhu, C.; Yin, D.; Feng, L.; Xu, B.; Guan, C.; Dou, K. Prognostic significance of prior ischemic stroke in patients with coronary artery disease undergoing percutaneous coronary intervention. Catheter. Cardiovasc. Interv. 2019, 93, 787–792. [Google Scholar] [CrossRef]
- Cosin-Sales, J.; Pizzi, C.; Brown, S.; Kaski, J.C. C-reactive protein, clinical presentation, and ischemic activity in patients with chest pain and normal coronary angiograms. J. Am. Coll. Cardiol. 2003, 41, 1468–1474. [Google Scholar] [CrossRef]
- Ridker, P.M.; Bhatt, D.L.; Pradhan, A.D.; Glynn, R.J.; MacFadyen, J.G.; Nissen, S.E.; Prominent, R.-I.; Investigators, S. Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: A collaborative analysis of three randomised trials. Lancet 2023, 401, 1293–1301. [Google Scholar] [CrossRef]
- McCabe, J.J.; Walsh, C.; Gorey, S.; Harris, K.; Hervella, P.; Iglesias-Rey, R.; Jern, C.; Li, L.; Miyamoto, N.; Montaner, J.; et al. C-Reactive Protein, Interleukin-6, and Vascular Recurrence After Stroke: An Individual Participant Data Meta-Analysis. Stroke 2023, 54, 1289–1299. [Google Scholar] [CrossRef] [PubMed]
- Han, D.; Chen, B.; Gransar, H.; Achenbach, S.; Al-Mallah, M.H.; Budoff, M.J.; Cademartiri, F.; Maffei, E.; Callister, T.Q.; Chinnaiyan, K.; et al. Prognostic significance of plaque location in non-obstructive coronary artery disease: From the CONFIRM registry. Eur. Heart J. Cardiovasc. Imaging 2022, 23, 1240–1247. [Google Scholar] [CrossRef] [PubMed]
- Eskerud, I.; Gerdts, E.; Larsen, T.H.; Simon, J.; Maurovich-Horvat, P.; Lonnebakken, M.T. Total coronary atherosclerotic plaque burden is associated with myocardial ischemia in non-obstructive coronary artery disease. Int. J. Cardiol. Heart Vasc. 2021, 35, 100831. [Google Scholar] [CrossRef] [PubMed]
- Mushtaq, S.; De Araujo Goncalves, P.; Garcia-Garcia, H.M.; Pontone, G.; Bartorelli, A.L.; Bertella, E.; Campos, C.M.; Pepi, M.; Serruys, P.W.; Andreini, D. Long-term prognostic effect of coronary atherosclerotic burden: Validation of the computed tomography-Leaman score. Circ. Cardiovasc. Imaging 2015, 8, e002332. [Google Scholar] [CrossRef] [PubMed]
- Arbab-Zadeh, A.; Fuster, V. The Risk Continuum of Atherosclerosis and its Implications for Defining CHD by Coronary Angiography. J. Am. Coll. Cardiol. 2016, 68, 2467–2478. [Google Scholar] [CrossRef] [PubMed]
- Yamaura, H.; Otsuka, K.; Ishikawa, H.; Shirasawa, K.; Fukuda, D.; Kasayuki, N. Determinants of Non-calcified Low-Attenuation Coronary Plaque Burden in Patients Without Known Coronary Artery Disease: A Coronary CT Angiography Study. Front. Cardiovasc. Med. 2022, 9, 824470. [Google Scholar] [CrossRef]
- Otsuka, K.; Fukuda, S.; Tanaka, A.; Nakanishi, K.; Taguchi, H.; Yoshiyama, M.; Shimada, K.; Yoshikawa, J. Prognosis of vulnerable plaque on computed tomographic coronary angiography with normal myocardial perfusion image. Eur. Heart J. Cardiovasc. Imaging 2014, 15, 332–340. [Google Scholar] [CrossRef]
- Gutierrez, E.; Flammer, A.J.; Lerman, L.O.; Elizaga, J.; Lerman, A.; Fernandez-Aviles, F. Endothelial dysfunction over the course of coronary artery disease. Eur. Heart J. 2013, 34, 3175–3181. [Google Scholar] [CrossRef]
- Lerman, A.; Cannan, C.R.; Higano, S.H.; Nishimura, R.A.; Holmes, D.R., Jr. Coronary vascular remodeling in association with endothelial dysfunction. Am. J. Cardiol. 1998, 81, 1105–1109. [Google Scholar] [CrossRef]
- Yeboah, J.; Crouse, J.R.; Hsu, F.C.; Burke, G.L.; Herrington, D.M. Brachial flow-mediated dilation predicts incident cardiovascular events in older adults: The Cardiovascular Health Study. Circulation 2007, 115, 2390–2397. [Google Scholar] [CrossRef]
- Suwaidi, J.A.; Hamasaki, S.; Higano, S.T.; Nishimura, R.A.; Holmes, D.R., Jr.; Lerman, A. Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation 2000, 101, 948–954. [Google Scholar] [CrossRef]
- Manganaro, A.; Ciraci, L.; Andre, L.; Trio, O.; Manganaro, R.; Saporito, F.; Oreto, G.; Ando, G. Endothelial dysfunction in patients with coronary artery disease: Insights from a flow-mediated dilation study. Clin. Appl. Thromb. Hemost. 2014, 20, 583–588. [Google Scholar] [CrossRef]
- Vaccarino, V.; Parsons, L.; Every, N.R.; Barron, H.V.; Krumholz, H.M. Sex-based differences in early mortality after myocardial infarction. National Registry of Myocardial Infarction 2 Participants. N. Engl. J. Med. 1999, 341, 217–225. [Google Scholar] [CrossRef]
- Waheed, N.; Elias-Smale, S.; Malas, W.; Maas, A.H.; Sedlak, T.L.; Tremmel, J.; Mehta, P.K. Sex differences in non-obstructive coronary artery disease. Cardiovasc. Res. 2020, 116, 829–840. [Google Scholar] [CrossRef]
- Schamroth Pravda, N.; Karny-Rahkovich, O.; Shiyovich, A.; Schamroth Pravda, M.; Rapeport, N.; Vaknin-Assa, H.; Eisen, A.; Kornowski, R.; Porter, A. Coronary Artery Disease in Women: A Comprehensive Appraisal. J. Clin. Med. 2021, 10, 4664. [Google Scholar] [CrossRef]
- Fernandez-Friera, L.; Penalvo, J.L.; Fernandez-Ortiz, A.; Ibanez, B.; Lopez-Melgar, B.; Laclaustra, M.; Oliva, B.; Mocoroa, A.; Mendiguren, J.; Martinez de Vega, V.; et al. Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study. Circulation 2015, 131, 2104–2113. [Google Scholar] [CrossRef]
- Baber, U.; Mehran, R.; Sartori, S.; Schoos, M.M.; Sillesen, H.; Muntendam, P.; Garcia, M.J.; Gregson, J.; Pocock, S.; Falk, E.; et al. Prevalence, impact, and predictive value of detecting subclinical coronary and carotid atherosclerosis in asymptomatic adults: The BioImage study. J. Am. Coll. Cardiol. 2015, 65, 1065–1074. [Google Scholar] [CrossRef]
- Witt, B.J.; Ballman, K.V.; Brown, R.D., Jr.; Meverden, R.A.; Jacobsen, S.J.; Roger, V.L. The incidence of stroke after myocardial infarction: A meta-analysis. Am. J. Med. 2006, 119, 354.e1–354.e9. [Google Scholar] [CrossRef]
- Hata, J.; Kiyohara, Y. Epidemiology of stroke and coronary artery disease in Asia. Circ. J. 2013, 77, 1923–1932. [Google Scholar] [CrossRef]
- Kim, J.Y.; Kang, K.; Kang, J.; Koo, J.; Kim, D.H.; Kim, B.J.; Kim, W.J.; Kim, E.G.; Kim, J.G.; Kim, J.M.; et al. Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society. J. Stroke 2019, 21, 42–59. [Google Scholar] [CrossRef]
- Hwang, I.C.; Lee, H.; Yoon, Y.E.; Choi, I.S.; Kim, H.L.; Chang, H.J.; Lee, J.Y.; Choi, J.A.; Kim, H.J.; Cho, G.Y.; et al. Risk stratification of non-obstructive coronary artery disease for guidance of preventive medical therapy. Atherosclerosis 2019, 290, 66–73. [Google Scholar] [CrossRef]
- Handberg, E.M.; Merz, C.N.B.; Cooper-Dehoff, R.M.; Wei, J.; Conlon, M.; Lo, M.C.; Boden, W.; Frayne, S.M.; Villines, T.; Spertus, J.A.; et al. Rationale and design of the Women’s Ischemia Trial to Reduce Events in Nonobstructive CAD (WARRIOR) trial. Am. Heart J. 2021, 237, 90–103. [Google Scholar] [CrossRef]
0 DV n = 1251 | 1 DV n = 506 | 2 DV n = 250 | 3 DV n = 76 | p-Value | |
---|---|---|---|---|---|
Age (years) | 59.2 ± 11.9 | 64.1 ± 10.7 | 65.8 ± 11.1 | 65.1 ± 12.9 | <0.001 |
Male | 629 (50.3) | 241 (47.6) | 101 (40.4) | 32 (42.1) | 0.024 |
BMI | 24.4 ± 3.6 | 24.6 ± 3.4 | 24.2 ± 3.1 | 24.3 ± 4.1 | 0.544 |
Smoking | 353 (28.2) | 158 (31.2) | 78 (31.2) | 24 (31.6) | 0.529 |
HTN | 561 (44.8) | 274 (54.2) | 162 (64.8) | 53 (69.7) | <0.001 |
DM | 231 (18.5) | 126 (24.9) | 81 (32.4) | 23 (30.3) | <0.001 |
Dyslipidemia | 229 (18.3) | 109 (21.5) | 57 (22.8) | 17 (22.4) | 0.216 |
CKD | 23 (1.8) | 14 (2.8) | 7 (2.8) | 2 (2.6) | 0.574 |
Previous CVA | 83 (6.6) | 33 (6.5) | 26 (10.4) | 15 (19.7) | <0.001 |
LV EF (%) | 59.3 ± 10.6 | 60.9 ± 8.9 | 61.6 ± 7.7 | 58.0 ± 11.8 | 0.013 |
Aspirin | 385 (30.8) | 278 (54.9) | 177 (70.8) | 51 (67.1) | <0.001 |
P2Y12 inhibitor | 46 (3.7) | 45 (8.9) | 29 (11.6) | 10 (13.2) | <0.001 |
Cilostazol | 19 (1.5) | 13 (2.6) | 14 (5.6) | 3 (4.0) | 0.001 |
Statin | 276 (22.1) | 184 (36.4) | 104 (41.6) | 31 (40.8) | <0.001 |
Beta blocker | 185 (14.8) | 87 (17.2) | 42 (16.8) | 17 (22.4) | 0.229 |
ACEi/ARB | 242 (19.3) | 105 (20.8) | 67 (26.8) | 15 (19.7) | 0.068 |
Vasodilator | 333 (26.6) | 201 (39.7) | 111 (44.4) | 38 (50.0) | <0.001 |
IVUS | 1 (0.1) | 4 (0.8) | 2 (0.8) | 1 (1.3) | 0.045 |
FFR | 0 (0.0) | 7 (1.4) | 4 (1.6) | 0 (0.0) | <0.001 |
HbA1c (%) | 6.4 ± 1.2 | 6.6 ± 1.3 | 7.1 ± 1.7 | 6.3 ± 1.0 | 0.058 |
Proximal LAD | 0 (0.0) | 83 (16.4) | 50 (20.0) | 28 (36.8) | <0.001 |
LAD (lesion) | 0 (0.0) | 260 (51.4) | 155 (62.0) | 52 (68.4) | <0.001 |
Mild stenosis (lesion) | 0 (0.0) | 164 (32.4) | 86 (34.4) | 27 (35.5) | |
Moderate stenosis (lesion) | 0 (0.0) | 96 (19.0) | 69 (27.6) | 25 (32.9) | |
LCx (lesion) | 0 (0.0) | 65 (12.9) | 109 (43.6) | 67 (88.2) | <0.001 |
Mild stenosis (lesion) | 0 (0.0) | 42 (8.3) | 56 (22.4) | 30 (39.5) | |
Moderate stenosis (lesion) | 0 (0.0) | 23 (4.6) | 53 (21.2) | 37 (48.7) | |
RCA (lesion) | 0 (0.0) | 114 (22.5) | 166 (66.4) | 76 (100.0) | <0.001 |
Mild stenosis (lesion) | 0 (0.0) | 75 (14.8) | 116 (46.4) | 39 (51.3) | |
Moderate stenosis (lesion) | 0 (0.0) | 39 (7.7) | 50 (20.0) | 37 (48.7) | |
Creatinine (mg/dL) | 0.9 ± 0.9 | 1.4 ± 1.7 | 1.0 ± 0.8 | 1.5 ± 1.7 | 0.046 |
Hemoglobin (g/dL) | 13.6 ± 1.8 | 13.6 ± 1.9 | 13.6 ± 1.8 | 13.1 ± 2.2 | 0.738 |
Hematocrit (%) | 39.6 ± 5.0 | 39.7 ± 4.6 | 39.8 ± 5.0 | 37.9 ± 5.8 | 0.876 |
Platelet (×109/L) | 238.9 ± 68.2 | 238.7 ± 63.5 | 236.3 ± 71.6 | 232.6 ± 76.5 | 0.853 |
White blood cell (×109/L) | 7.9 ± 10.6 | 7.8 ± 6.2 | 8.3 ± 4.3 | 7.3 ± 2.6 | 0.939 |
Total cholesterol (mg/dL) | 181.1 ± 43.1 | 183.5 ± 41.8 | 186.9 ± 53.3 | 169.4 ± 38.0 | 0.649 |
Triglyceride (mg/dL) | 129.7 ± 113.4 | 131.0 ± 81.0 | 142.7 ± 105.2 | 105.9 ± 59.2 | 0.485 |
HDL cholesterol (mg/dL) | 43.2 ± 11.6 | 43.0 ± 11.8 | 40.8 ± 11.7 | 43.7 ± 12.1 | 0.346 |
LDL cholesterol (mg/dL) | 107.8 ± 33.5 | 109.5 ± 35.6 | 106.5 ± 41.6 | 102.1 ± 29.6 | 0.240 |
C-Reactive protein (mg/dL) | 1.1 ± 3.1 | 1.0 ± 5.1 | 1.8 ± 3.5 | 0.5 ± 0.6 | 0.116 |
Albumin | 4.3 ± 1.2 | 4.4 ± 4.7 | 4.2 ± 0.6 | 4.2 ± 0.3 | 0.114 |
0 DV n = 1251 | 1 DV n = 506 | 2 DV n = 250 | 3 DV n = 76 | p-Value | |
---|---|---|---|---|---|
MACCEs | 78 (6.2) | 33 (6.5) | 17 (6.8) | 14 (18.4) | <0.001 |
All-cause death | 118 (9.4) | 45 (8.9) | 28 (11.2) | 9 (11.8) | 0.680 |
Cardiac death | 31 (2.5) | 11 (2.2) | 3 (1.2) | 1 (1.3) | 0.597 |
Myocardial infarction | 3 (0.2) | 5 (1.0) | 1 (0.4) | 3 (4.0) | <0.001 |
Stroke | 49 (3.9) | 18 (3.6) | 13 (5.2) | 10 (13.2) | 0.001 |
Univariate HR (95% CI) | p-Value | Multivariate HR a (95% CI) | p-Value | |
---|---|---|---|---|
MACCEs | ||||
0 DVs (reference) | 1.00 | - | 1.00 | - |
1 DV | 0.98 (0.65–1.48) | 0.928 | 0.83 (0.54–1.27) | 0.386 |
2 DVs | 1.05 (0.62–1.78) | 0.854 | 0.70 (0.40–1.23) | 0.212 |
3 DVs | 2.97 (1.68–5.24) | <0.001 | 2.09 (1.15–3.79) | 0.016 |
All-cause death | ||||
0 DVs (reference) | 1.00 | - | 1.00 | - |
1 DV | 0.87 (0.62–1.12) | 0.434 | 0.77 (0.54–1.10) | 0.148 |
2 DVs | 1.11 (0.74–1.68) | 0.612 | 0.85 (0.55–1.32) | 0.466 |
3 DVs | 1.13 (0.57–2.22) | 0.734 | 0.77 (0.39–1.55) | 0.469 |
Cardiac death | ||||
0 DVs (reference) | 1.00 | - | 1.00 | - |
1 DV | 0.83 (0.42–1.65) | 0.595 | 0.80 (0.39–1.65) | 0.548 |
2 DVs | 0.46 (0.14–1.51) | 0.201 | 0.37 (1.11–1.29) | 0.118 |
3 DVs | 0.49 (0.07–3.60) | 0.485 | 0.45 (0.06–3.35) | 0.433 |
Myocardial infarction | ||||
0 DVs (reference) | 1.00 | - | 1.00 | - |
1 DV | 3.92 (0.94–16.42) | 0.061 | 3.31 (0.73–14.99) | 0.120 |
2 DVs | 1.60 (0.17–15.40) | 0.683 | 1.44 (0.13–15.77) | 0.765 |
3 DVs | 15.65 (3.16–77.56) | <0.001 | 15.17 (2.37–97.25) | 0.004 |
Stroke | ||||
0 DVs (reference) | 1.00 | - | 1.00 | - |
1 DV | 0.85 (0.49–1.45) | 0.540 | 0.67 (0.38–1.16) | 0.152 |
2 DVs | 1.27 (0.69–2.34) | 0.441 | 0.74 (0.39–1.42) | 0.362 |
3 DVs | 3.30 (1.67–6.52) | <0.001 | 2.04 (1.01–4.16) | 0.049 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Jung, J.; Lee, S.-N.; Her, S.-H.; Yoo, K.-D.; Moon, K.-W.; Moon, D.; Jang, W.-Y. Long-Term Clinical Impact of Patients with Multi-Vessel Non-Obstructive Coronary Artery Disease. Life 2023, 13, 2119. https://doi.org/10.3390/life13112119
Jung J, Lee S-N, Her S-H, Yoo K-D, Moon K-W, Moon D, Jang W-Y. Long-Term Clinical Impact of Patients with Multi-Vessel Non-Obstructive Coronary Artery Disease. Life. 2023; 13(11):2119. https://doi.org/10.3390/life13112119
Chicago/Turabian StyleJung, Jin, Su-Nam Lee, Sung-Ho Her, Ki-Dong Yoo, Keon-Woong Moon, Donggyu Moon, and Won-Young Jang. 2023. "Long-Term Clinical Impact of Patients with Multi-Vessel Non-Obstructive Coronary Artery Disease" Life 13, no. 11: 2119. https://doi.org/10.3390/life13112119