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 .

In-hospital and 30-day major adverse cardiac events in patients referred for ST-segment elevation myocardial infarction in Dhaka, Bangladesh

“…On day 31, following discharge from hospital, study physicians made calls to subjects/family members to record any MACE during the past 30 days. A MACE was defined as all-cause death, non-fatal myocardial infarction, or a revascularization procedure including Percutaneous coronary intervention (PCI) or Cronary artery bypass grafting (CABG) [ 27 ]. Similar to a previously published study, if more than one MACE occurred during the follow-up period, the most severe endpoint (all-cause death > myocardial infarction > revascularization) was selected for the 30-day MACE analysis [ 28 ].…”

Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Patients with Obesity and Cardiovascular Diseases: A Systematic Review and Meta-Analysis

“…Typically, the reduction of those CV risk factors is expected to be followed by the reduction of Major Adverse Cardiovascular Events (MACE; i.e., composites of CV death, myocardial infarction (MI), stroke, coronary revascularization or hospitalization for HF [11,12]). However, recent studies showed conflicting results, suggesting that obesity might provide better CV outcomes in specific populations (i.e., "obesity paradox") [13][14][15][16].…”

Reduction of Major Adverse Cardiovascular Events (MACE) after Bariatric Surgery in Obese Patients with Cardiovascular Diseases: A Systematic Review and Meta-Analysis

“…Typically, the reduction of those CV risk factors is expected to be followed by the reduction of Major Adverse Cardiovascular Events (MACE; i.e., composite of CV death, myocardial infarction [MI], stroke, coronary revascularization or hospitalization for HF (8,9)). However, recent studies showed conflicting results, suggesting that obesity might provide better CV outcomes in specific populations (i.e., "obesity paradox") (10)(11)(12).…”

“…Several studies have reported the benefits of bariatric surgery in patients with obesity, including the improvements of body fat distribution and CV risk factors such as dyslipidemia, (pre)hypertension, insulin resistance, (pre)diabetes, non-alcoholic fatty liver disease, inflammation, vascular reactivity and obstructive sleep apnea (6). Typically, the reduction of those CV risk factors is expected to be followed by the reduction of Major Adverse Cardiovascular Events (MACE; i.e., composite of CV death, myocardial infarction [MI], stroke, coronary revascularization or hospitalization for HF (8, 9)). However, recent studies showed conflicting results, suggesting that obesity might provide better CV outcomes in specific populations (i.e., “obesity paradox”) (10-12).…”