Prognosis of non-obstructive coronary artery disease in men and women: a retrospective cohort study

Abstract

Ischemic heart disease is currently the leading cause of death in Brazil. However, around 50% of patients with typical angina who undergo coronary angiography do not have significant coronary stenosis. In patients with angina and nonobstructive coronary artery disease (NOCAD), the main etiopathogenic mechanisms are coronary microvascular dysfunction (CMD) and coronary spasm in epicardial arteries and/or microcirculation. CMD is defined as increased vascular resistance associated or not with inadequate microcirculation vasodilation in stress situations, which can result in myocardial ischemia. In patients with ACNO, vasospastic angina, a variant of angina pectoris, is a common cardiac functional alteration caused by coronary spasms and is associated with a variety of clinical scenarios, such as stable angina, sudden cardiac death, acute coronary syndrome, arrhythmias, and syncope. Recent studies indicate that patients with CMD have a high risk of adverse cardiovascular events, which shows the importance of diagnosis and follow-up of these patients. Furthermore, there are indications that angina pectoris in DACNO is more common in women than men. However, we do not have solid information about the prognosis of nonobstructive CAD in a comparative way between men and women. This study will retrospectively analyze the clinical and laboratory characteristics, echocardiogram, coronary angiography, and the number of hospitalizations, cardiovascular deaths, and all causes of death of patients with NOCAD at a tertiary outpatient care center in the last ten years from January 2012 to December 2012. 2021.