Pattern of coronary artery disease in high-risk patients without prior myocardial infraction

Abstract

Objective This study aimed to assess the causes, risk factors, outcome, and recommendation of patients with coronary artery disease without prior obstruction. Materials and methods Medline databases (PubMed, Circulation, American Society of Echocardiography, Journal of American Colleague of Cardiology, and ScienceDirect) and also materials available on the internet. The search was performed in the electronic databases from 2012 to 2017. The initial search presented 60 articles of which 23 met the inclusion criteria. The articles studied the pattern of coronary artery disease in patients with risk factors without prior obstruction. If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, adequate information, and defined assessment measures. Comparisons were made by a structured review with the results tabulated. Findings In total, 27 potentially relevant publications were included. The studies indicate that cardiovascular risk factors have a differential effect on women, and some risk factors are more common in women than in men. Conclusion Patients with angina and nonobstructive coronary angiograms are predominantly women, and many have a prognosis that is not as benign as commonly thought. Therapy should be directed at symptom relief; aggressive anti-ischemic medication should be applied when risk factors are present or when the prognostic risk is high.