Non-Obstructive CAD Still Causes Heart Attacks

Non-obstructive plaques in patients with coronary artery disease (CAD) can still rupture and cause heart attacks, according to a recent study.

Researchers discovered the association between CAD and a 28% to 44% increased risk of adverse cardiac events (eg, heart attack) or mortality.

For the study, investigators examined 40,872 participants who had an elective cardiac angiography from October 2007 to September 2012.  Researchers categorized the patient’s condition: normal, non-obstructive, and obstructive CAD.
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The results suggested that mortality and heart attack rates –1 year after angiography—increased with CAD severity; this occurred among participants with non-obstructive CAD as well.

Thomas M. Maddox, MD, MSc, the study’s lead researcher and associate professor of medicine at the University of Colorado School of Medicine in Denver, observed that non-obstructive CAD may initially appear less threatening—compared to obstructive CAD which blocks blood flow—on angiography tests, but it still possess significant risk for death and heart attacks.

“Dismissing non-obstructive CAD as harmless could be dangerous. Our findings show there is indeed a risk, that non-obstructive damage can lead to heart attacks just like obstructive disease, and that we should consider preventive therapies for these patients,” said Maddox.

Maddox further notes that non-obstructive CAD patients should seek out preventative measures with their physicians. These preventative therapies—overseen by a physician—include healthy diets, exercise, weight loss, quitting smoking, and medications such as aspirin and statins.

This study was presented at the American Heart Association’s Quality of Care and Outcomes Research 2014 Scientific Sessions.

-Michelle Canales

Reference:

American Heart Association. Heart disease without coronary plaque buildup linked to heart attack risk [press release]. June 4, 2014. http://newsroom.heart.org/news/heart-disease-without-coronary-plaque-buildup-linked-to-heart-attack-risk. Accessed June 6, 2014.