LAUSR

More than 10% of patients presenting with symptoms suggestive of acute myocardial ischaemia have no significant atherosclerotic plaques in coronary angiography. The management and longer term prognosis of these patients has been a subject of debate. The aim of the study was to assess the 3-year prognosis of patients with the diagnosis ACS (acute coronary syndrome) in Swietokrzyskie region of Poland based on data from the Polish National ORPKI Registry. Between 2014–2015, 9771 patients with ACS who underwent coronary angiography entered the registry and were included in the study. Of them, 2141 had no evidence of atherosclerosis or no significant stenosis on coronary angiography. Data on death, myocardial infarction, stroke, heart failure and cardiac hospitalization were compared between ACS patients with and without significant atherosclerotic plaques in coronary angiography. The results are presented in the table. Death and cardiovascular events at 3-year follow-up ACS with significant stenosis ACS without significant stenosis p-value Death 14.4% 7.8% <0.001 Myocardial infarction 16.8% 11.6% 0.04 Stroke 6.8% 2.5% 0.01 Heart failure 38.0% 34.0% 0.19 Cardiac hospitalization 50.3% 22.7% <0.001 Patients who have presented with ACS and had no significant stenosis on angiography have had generally better 3-year prognosis that patients with ACS with significant stenosis. However, cardiovascular events, especially heart failure have not been uncommon in this group of patients.