Management of acute coronary syndrome (ACS) patients with non-obstructive epicardial coronary artery disease (CAD) remains poorly understood.
ACS patients with non-obstructive CAD are less likely to receive effective cardiac medications upon discharge from the hospital.
We identified patients hospitalized with ACS that underwent coronary angiography and had 6-month follow-up. Patients were grouped by CAD severity: non-obstructive CAD (<50% blockage in all vessels) or obstructive CAD (≥50% blockage in ≥1 vessels). Data were collected on demographics, medications at discharge, and adverse outcomes at 6 months, for all patients.
Of the 2,264 ACS patients included in the study: 123 patients had non-obstructive CAD and 2,141 had obstructive CAD. Cardiac risk factors including hypertension and diabetes were common among patients with non-obstructive CAD. Men and women with non-obstructive CAD were less likely to receive cardiac medications compared to patients with obstructive CAD including aspirin (87.8% vs. 95.0%, p=0.001), beta-blockers (74.0% vs. 89.2%, p<0.001), or statins (69.1% vs. 81.2%, p=0.001). No gender-related differences in discharge medications were observed for patients with nonobstructive CAD. However women with non-obstructive CAD had similar rates of cardiac-related rehospitalization as men with obstructive CAD (23.3% and 25.9%, respectively).
Patients with non-obstructive CAD are less likely to receive evidence-based medications compared to patients with obstructive CAD, despite the presence of CAD risk factors and occurrence of an ACS event. Further research is warranted to determine if receipt of effective cardiac medications among patients with non-obstructive CAD would reduce cardiac related events.