Abstract 1206: Survival Patterns in Patients with Coronary Microvascular Dysfunction
Introduction: Coronary microvascular dysfunction is a recognized cause myocardial ischemia, commonly presenting with chest pain. It is generally thought to have a benign prognosis despite an abnormal stress test result.
Methods: Our exercise stress test and angiographic data bases were searched for patients with positive stress test (ST depression of ≤1 mm)and a coronary angogram within a year. Significant coronary artery disease (CAD) was defined as >70% stenosis of an epicardial coronary artery or >50% stenosis of the left main stem. Mortality data was obtained from National Death Index.
Results: Of the 935 patients meeting the inclusion criteria, 324 had significant epicardial CAD and the remaining 611 were considered to have coronary microvascular dysfunction. Compared to those with significant epicardial CAD, patients with microvascular dysfunction were younger (63±10 vs. 65±10 years, p<0.0001), but similar in terms of gender, LV size, LV wall thickness, EF (mean 58%) and stress heart rate achieved (mean 133 bpm). Those with “microvascular dysfunction” and totally normal coronary arteriogram were slightly younger (age 58±11 years, p<0.0001), and had female preponderance (67% vs. 30%, p<0.0001). Those with microvascular dysfunction had a better survival compared to those with significant epicardial CAD, but worse than that expected for age and gender matched population (p<0.0001, figure⇓).
Coronary microvascular dysfunction is common.
Survival of these patients is better than those with significant epicardial CAD, but worse than age and gender matched general population.