Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population

Byoung Geol Choi, Seung-Woon Rha, Seong Gyu Yoon, Cheol Ung Choi, Min Woo Lee, Suhng Wook Kim

Research output: Contribution to journalArticle

Abstract

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 .

Original languageEnglish
Pages (from-to)e010541
JournalJournal of the American Heart Association
Volume8
Issue number12
DOIs
Publication statusPublished - 2019 Jun 18

Fingerprint

Coronary Stenosis
Angina Pectoris
Chest Pain
Coronary Artery Disease
Spasm
Dyslipidemias
Population
Coronary Vessels
Regression Analysis
Hospitalization
Heart Failure
Stroke
Myocardial Infarction

Keywords

  • clinical events
  • coronary angiography
  • coronary artery dissection
  • risk assessment
  • risk factor
  • vasospasm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{f404fb115f5c41b68bc301776e7b0d78,
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",
abstract = "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 .",
keywords = "clinical events, coronary angiography, coronary artery dissection, risk assessment, risk factor, vasospasm",
author = "Choi, {Byoung Geol} and Seung-Woon Rha and Yoon, {Seong Gyu} and Choi, {Cheol Ung} and Lee, {Min Woo} and Kim, {Suhng Wook}",
year = "2019",
month = "6",
day = "18",
doi = "10.1161/JAHA.118.010541",
language = "English",
volume = "8",
pages = "e010541",
journal = "Journal of the American Heart Association",
issn = "2047-9980",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population

AU - Choi, Byoung Geol

AU - Rha, Seung-Woon

AU - Yoon, Seong Gyu

AU - Choi, Cheol Ung

AU - Lee, Min Woo

AU - Kim, Suhng Wook

PY - 2019/6/18

Y1 - 2019/6/18

N2 - 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 .

AB - 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 .

KW - clinical events

KW - coronary angiography

KW - coronary artery dissection

KW - risk assessment

KW - risk factor

KW - vasospasm

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U2 - 10.1161/JAHA.118.010541

DO - 10.1161/JAHA.118.010541

M3 - Article

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VL - 8

SP - e010541

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 12

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