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OR CORONARY ARTERY SPASM WITHOUT OBSTRUCTIVE LESIONS
459 JACC April 5, 2016 Volume 67, Issue 13
Acute Coronary Syndromes TWO-YEAR CLINICAL OUTCOMES OF ACUTE MYOCARDIAL INFARCTION PATIENTS WITH MYOCARDIAL BRIDGE AND/OR CORONARY ARTERY SPASM WITHOUT OBSTRUCTIVE LESIONS Moderated Poster Contributions Acute Coronary Syndromes Moderated Poster Theater, Poster Area, South Hall A1 Sunday, April 03, 2016, 4:15 p.m.-4:25 p.m. Session Title: Not as Simple as You Think: Not All MIs Are Atherosclerosis Abstract Category: 14. Acute Coronary Syndromes: Clinical Presentation Number: 1237M-05 Authors: Baek Ju Yeol, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Dong Joo Oh, Myung Ho Jeong, other Korea Acute Myocardial Infarction Registry Investigators, Cardiovascular Center, Cheong-Ju St. Mary’s Hospital, Cheong-Ju, South Korea, Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea
Background: Coronary artery spasm (CAS) has been identified as an alternative cause for acute myocardial infarction (AMI) patients (pts). However there is few data on the prognosis in these pts. Therefore we aimed to compare the prognosis between AMI pts due to myocardial bridge (MB) and/or CAS without obstructive lesions and AMI due to obstructive lesions.
Methods: A total of 43,071AMI pts in the Korea AMI Registry (KAMIR) were grouped according to AMI due to MB and/or CAS without obstructive lesions (MB-CAS MI; N=793) and AMI due to obstructive lesions (Occlusive MI; N=42,278). We compared 2-year major adverse cardiac events (MACE) defined as composite of cardiac death (CD), any myocardial infarction (MI), repeat revascularization (RR) between the two groups. Results: After baseline adjustment using 1:1 propensity score stratification, the incidence of MACE and RR in pts with MB-CAS MI was significantly lower than those of pts with occlusive MI at 2 years. However, the incidence of CD and re-AMI were similar between the two groups(figure).
Conclusions: In overall population with AMI, the incidence of MACE and RR of MB-CAS MI was significantly lower than those of occlusive AMI up to 2 years, which is attributable to relatively lower rate of RR. However the incidence of CD and re-AMI in the pts with MB-CAS MI was similar with those of occlusive AMI., suggesting similar intensive care and close clinical follow up would be required for this particular subset of pts.
Acute Coronary Syndromes TWO-YEAR CLINICAL OUTCOMES OF ACUTE MYOCARDIAL INFARCTION PATIENTS WITH MYOCARDIAL BRIDGE AND/OR CORONARY ARTERY SPASM WITHOUT OBSTRUCTIVE LESIONS Moderated Poster Contributions Acute Coronary Syndromes Moderated Poster Theater, Poster Area, South Hall A1 Sunday, April 03, 2016, 4:15 p.m.-4:25 p.m. Session Title: Not as Simple as You Think: Not All MIs Are Atherosclerosis Abstract Category: 14. Acute Coronary Syndromes: Clinical Presentation Number: 1237M-05 Authors: Baek Ju Yeol, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Dong Joo Oh, Myung Ho Jeong, other Korea Acute Myocardial Infarction Registry Investigators, Cardiovascular Center, Cheong-Ju St. Mary’s Hospital, Cheong-Ju, South Korea, Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea
Background: Coronary artery spasm (CAS) has been identified as an alternative cause for acute myocardial infarction (AMI) patients (pts). However there is few data on the prognosis in these pts. Therefore we aimed to compare the prognosis between AMI pts due to myocardial bridge (MB) and/or CAS without obstructive lesions and AMI due to obstructive lesions.
Methods: A total of 43,071AMI pts in the Korea AMI Registry (KAMIR) were grouped according to AMI due to MB and/or CAS without obstructive lesions (MB-CAS MI; N=793) and AMI due to obstructive lesions (Occlusive MI; N=42,278). We compared 2-year major adverse cardiac events (MACE) defined as composite of cardiac death (CD), any myocardial infarction (MI), repeat revascularization (RR) between the two groups. Results: After baseline adjustment using 1:1 propensity score stratification, the incidence of MACE and RR in pts with MB-CAS MI was significantly lower than those of pts with occlusive MI at 2 years. However, the incidence of CD and re-AMI were similar between the two groups(figure).
Conclusions: In overall population with AMI, the incidence of MACE and RR of MB-CAS MI was significantly lower than those of occlusive AMI up to 2 years, which is attributable to relatively lower rate of RR. However the incidence of CD and re-AMI in the pts with MB-CAS MI was similar with those of occlusive AMI., suggesting similar intensive care and close clinical follow up would be required for this particular subset of pts.