The study compared the 2-year outcomes of patients diagnosed with acute myocardial
infarction (AMI) triggered by coronary artery atherosclerosis and AMI caused by coronary
artery spasm. A total of 36,797 patients in the Korea AMI Registry were grouped into
2 categories—(1) AMI due to coronary artery spasm without stenotic lesion (CAS-AMI,
n = 484); and (2) AMI induced by coronary artery atherosclerosis (CAA-AMI, n = 36,313).
The major clinical outcomes of the 2 groups were compared over a 2-year clinical follow-up
period. Major adverse cardiac events (MACE) were defined as the composite of total
death, nonfatal myocardial infarction, and repeat revascularization. The incidence
of MACE (7.1% vs 11.1%; p = 0.007) and repeat revascularization (0.4% vs 4.2%; p <0.001)
in the CAS-AMI group were significantly lower than in the CAA-AMI group at 2 years.
However, the incidence of total death and nonfatal myocardial infarction was similar
in both the groups. Aborted cardiac arrest was strongly associated with 2-year mortality
in the CAS-AMI group (hazard ratios 13.5, 95% confidence interval 5.34 to 34.15, p
<0.001) The incidence of MACE in CAS-AMI patients was significantly lower than in
the CAA-AMI group of patients up to 2 years due to the relatively lower rate of repeat
revascularization in CAS-AMI patients. However, the incidence of total death or nonfatal
myocardial infarction in CAS-AMI patients was not different from that of patients
with CAA-AMI.
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Article info
Publication history
Published online: August 23, 2019
Received in revised form:
August 2,
2019
Received:
April 26,
2019
Footnotes
Funding Source: There was no relationship and interesting with industry.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
