It has become abundantly clear that coronary events (i.e., MI) are not simply a result of “clogged pipes.” To the contrary, it has been documented that the majority of plaque ruptures occur within coronary arteries that have been atherosclerotically categorized as “non-obstructive.” In this report, obstructive coronary disease (obCAD) was defined as ≥ 50% stenosis of the left main coronary artery or ≥ 70% stenosis in other coronary arteries. Non-obstructive coronary disease (nobCAD) was defined as 20-49% stenosis, and < 20% stenosis was categorized as “no apparent CAD” (napCAD).
The authors of this report studied all patients who underwent coronary arteriography in Veteran Administration hospitals from 2007-2012 (n = 37,684). Within this cohort, 8384 patients were reported to have noCAD. They tracked the rate of admission for acute MI in the year following arteriography.
Compared to persons with no apparent CAD, the hazard ratio for MI at 1 year for persons with nobCAD was 2.0-4.5 (dependent upon the number of vessels involved); for persons with obCAD, the hazard ratio was 9.0-19.5 (dependent upon the number of vessels involved).
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