To investigate the 5-year survival of patients with coronary angiographic evidence of no coronary artery disease (CAD), nonobstructive CAD, and revascularized 1-vessel, 2-vessel, and 3-vessel obstructive CAD.
Coronary angiography was performed in 2,057 unselected patients, mean age 69 years (57% men and 43% women), with chest pain.
Of 2,057 patients, 760 (37%) had obstructive CAD with >50% obstruction of at least 1 major coronary artery and were revascularized, 695 (34%) had nonobstructive CAD (<50% obstruction), and 602 (29%) had normal coronary arteries. At 60 ± 16-month follow-up, all-cause mortality occurred in 41 of 602 patients (7%) with no CAD (group 1), in 80 of 695 patients (12%) with nonobstructive CAD (group 2), in 50 of 302 patients (17%) with revascularized 1-vessel obstructive CAD (group 3), in 47 of 201 patients (23%) with 2-vessel revascularized obstructive CAD (group 4), and in 72 of 257 patients (28%) with 3-vessel revascularized obstructive CAD (group 4). Log-rank tests to compare survival curves among the 5 groups showed p = 0.004 for groups 1 versus 2; p <0.0001 for groups 1 versus 3, 1 versus 4, 1 versus 5, 2 versus 4, and 2 versus 5; and p = 0.007 for groups 3 versus 5.
In conclusion, patients with nonobstructive CAD had a worse survival than those with no CAD, a nonsignificant difference in survival than those with revascularized 1-vessel obstructive CAD, and a better survival than those with revascularized 2-vessel or 3-vessel obstructive CAD.
Patients with nonobstructive CAD should be treated with intensive risk factor management as well as with drug therapy recommended for obstructive CAD.
Kiran Chilappa, No Financial Disclosure Information; No Product/Research Disclosure Information