Table 2

Tabulation of Findings in NSTE ACS Patients With Nonobstructive CAD

  • Overall, ∼10% of NSTE ACS patients have nonobstructive CAD.

  • Sex differences in patient characteristics and outcomes are similar to those with obstructive CAD.

    • Women are twice as likely to have nonobstructive CAD than men.

    • Those with nonobstructive CAD have lower event rates than patients with obstructive CAD.

    • Women are less likely to undergo early angiography and to receive guideline-recommended therapies, suggesting opportunities for improved management.

  • Death or MI occurs in ∼2% of these patients by 30 days.

  • Although death/MI rates are low, they are not negligible. Furthermore, patients such as those selected for analyses (e.g., reaching hospital alive and undergoing early angiography and/or consenting to a randomized trial) are recognized to have lower events rates than those in the all-inclusive ACS population.

  • The presence of nonobstructive CAD alone does not justify dismissing opportunities for secondary prevention.

ACS = acute coronary syndrome(s); CAD = coronary artery disease; MI = myocardial infarction; NSTE = non–ST-segment elevation.