Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population
Background Significant coronary artery disease has a well‐known association with long‐term adverse cardiovascular events. In this study, we aimed to evaluate its association with long‐term major adverse clinical events (MACE) up to 5 years in patients who presented with chest pain without significan...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2019-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.118.010541 |
| _version_ | 1811275038898257920 |
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| author | Byoung Geol Choi Seung‐Woon Rha Seong Gyu Yoon Cheol Ung Choi Min Woo Lee Suhng Wook Kim |
| author_facet | Byoung Geol Choi Seung‐Woon Rha Seong Gyu Yoon Cheol Ung Choi Min Woo Lee Suhng Wook Kim |
| author_sort | Byoung Geol Choi |
| collection | DOAJ |
| description | Background Significant coronary artery disease has a well‐known association with long‐term adverse cardiovascular events. In this study, we aimed to evaluate its association with long‐term major adverse clinical events (MACE) up to 5 years in patients who presented with chest pain without significant coronary artery disease. Methods and Results A total of 5890 subjects with chest pain without significant coronary artery disease were prospectively enrolled in this study. The mean follow‐up duration was 3.4 years. Multivariable Cox proportional hazards regression analysis was performed for assessing the independent risk factors for MACE or sustained angina pectoris. MACE was defined as the composite of total death, myocardial infarction, coronary revascularization, stroke, and hospitalization because of heart failure. Ninety‐one (2.2%) patients developed MACE, and 309 (8.1%) patients developed sustained angina pectoris, both within 5 years. In multivariable Cox proportional hazards regression analysis, the risk of MACE was significantly associated with age (per 5 years; hazard ratio [HR], 1.44; 95% CI, 1.30–1.60) and insignificant coronary stenosis (30%–70%; HR, 2.03; 95% CI; 1.28–3.21). The risk of sustained angina pectoris was significantly associated with age (per 5 years; HR, 1.05; 95% CI, 1.01–1.11), dyslipidemia (HR, 1.34; 95% CI, 1.06–1.70), insignificant coronary stenosis (HR, 2.54; 95% CI, 1.94–3.31), coronary artery spasm (HR, 1.42; 95% CI, 1.11–1.80), and myocardial bridge (HR, 1.37; 95% CI, 1.04–1.81). Conclusions In patients without significant CAD, aging and insignificant coronary stenosis have a strong association with future long‐term MACE. Also, aging, dyslipidemia, insignificant coronary stenosis, coronary artery spasm, and myocardial bridge are strongly associated with future angina pectoris. |
| first_indexed | 2024-04-12T23:30:56Z |
| format | Article |
| id | doaj.art-f3288f0375624f3483e8e22d37768ea6 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T23:30:56Z |
| publishDate | 2019-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-f3288f0375624f3483e8e22d37768ea62022-12-22T03:12:18ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802019-06-0181210.1161/JAHA.118.010541Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean PopulationByoung Geol Choi0Seung‐Woon Rha1Seong Gyu Yoon2Cheol Ung Choi3Min Woo Lee4Suhng Wook Kim5Research Institute of Health Sciences Korea University College of Health Science Seoul KoreaKorea Cardiovascular Center Korea University Guro Hospital Seoul KoreaDepartment of Medicine Korea University Graduate School Seoul KoreaKorea Cardiovascular Center Korea University Guro Hospital Seoul KoreaResearch Institute of Health Sciences Korea University College of Health Science Seoul KoreaDepartment of Health and Safety Convergence Science Korea University Graduate School Seoul KoreaBackground Significant coronary artery disease has a well‐known association with long‐term adverse cardiovascular events. In this study, we aimed to evaluate its association with long‐term major adverse clinical events (MACE) up to 5 years in patients who presented with chest pain without significant coronary artery disease. Methods and Results A total of 5890 subjects with chest pain without significant coronary artery disease were prospectively enrolled in this study. The mean follow‐up duration was 3.4 years. Multivariable Cox proportional hazards regression analysis was performed for assessing the independent risk factors for MACE or sustained angina pectoris. MACE was defined as the composite of total death, myocardial infarction, coronary revascularization, stroke, and hospitalization because of heart failure. Ninety‐one (2.2%) patients developed MACE, and 309 (8.1%) patients developed sustained angina pectoris, both within 5 years. In multivariable Cox proportional hazards regression analysis, the risk of MACE was significantly associated with age (per 5 years; hazard ratio [HR], 1.44; 95% CI, 1.30–1.60) and insignificant coronary stenosis (30%–70%; HR, 2.03; 95% CI; 1.28–3.21). The risk of sustained angina pectoris was significantly associated with age (per 5 years; HR, 1.05; 95% CI, 1.01–1.11), dyslipidemia (HR, 1.34; 95% CI, 1.06–1.70), insignificant coronary stenosis (HR, 2.54; 95% CI, 1.94–3.31), coronary artery spasm (HR, 1.42; 95% CI, 1.11–1.80), and myocardial bridge (HR, 1.37; 95% CI, 1.04–1.81). Conclusions In patients without significant CAD, aging and insignificant coronary stenosis have a strong association with future long‐term MACE. Also, aging, dyslipidemia, insignificant coronary stenosis, coronary artery spasm, and myocardial bridge are strongly associated with future angina pectoris.https://www.ahajournals.org/doi/10.1161/JAHA.118.010541clinical eventscoronary artery dissectioncoronary angiographyrisk factorrisk assessmentvasospasm |
| spellingShingle | Byoung Geol Choi Seung‐Woon Rha Seong Gyu Yoon Cheol Ung Choi Min Woo Lee Suhng Wook Kim Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease clinical events coronary artery dissection coronary angiography risk factor risk assessment vasospasm |
| title | Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population |
| title_full | Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population |
| title_fullStr | Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population |
| title_full_unstemmed | Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population |
| title_short | Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population |
| title_sort | association of major adverse cardiac events up to 5 years in patients with chest pain without significant coronary artery disease in the korean population |
| topic | clinical events coronary artery dissection coronary angiography risk factor risk assessment vasospasm |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.118.010541 |
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