eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2023
vol. 19
 
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abstract:
Original paper

Prognostic significance of small vessel coronary artery disease in patients with acute coronary syndromes treated with percutaneous coronary interventions

Zofia Kampka
1
,
Mateusz Drabczyk
1
,
Magdalena Żak
1
,
Katarzyna Mizia-Stec
1
,
Maciej T. Wybraniec
1

  1. First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia in Katowice, Poland
Adv Interv Cardiol 2023; 19, 1 (71): 14–21
DOI: https://doi.org/10.5114/aic.2023.124748
Online publish date: 2023/02/01
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Introduction:
Small vessel disease (SVD) usually refers to atherosclerosis within vessels of diameter of < 2.5 mm. Conflicting data exist regarding the outcomes of its revascularization.

Aim:
To evaluate the outcome of invasive treatment in patients with acute coronary syndromes (ACS) and SVD and the predictors of angina recurrence after percutaneous coronary intervention (PCI).

Material and methods:
This was an observational, retrospective, single-center study. It covered consecutive 127 patients (26.77% women; median age: 69.74 ±8.97 years) with ACS who underwent PCI in the Upper-Silesian Medical Center in Katowice between 2018 and 2020. The study population was stratified by means of presence of SVD defined by PCI of the culprit artery with a diameter of ≤ 2.5 mm. The major adverse cardiac and cerebrovascular events (MACCE) and angina recurrence were analyzed in a 12-month follow-up period.

Results:
Overall 99 (77.95%) patients were diagnosed with small-vessel coronary artery disease. MACCE were documented in 14 (11.02%) patients. Univariate analysis revealed the following factors associated with MACCE: left ventricle ejection fraction (LVEF) (OR = 0.95, p = 0.0212), left main (LM) stenting (OR = 18.17, p = 0.0216), number of former PCIs (OR = 1.48, p = 0.0235). According to logistic regression analysis the factors were LM stenting (OR = 20.04, p = 0.0216) and number of former PCIs (OR = 1.53, p = 0.0203). Patients with SVD had more often refractory or recurrent angina in symptomatic class III/IV on follow-up (52.53% vs. 10.71%, p < 0.001).

Conclusions:
Outcome of invasive treatment in patients with ACS is related to LM stenting and former PCIs but not to SVD occurrence. Patients with SVD have a high rate of recurrent/refractory angina despite successful PCI in this clinical setting.

keywords:

small vessel coronary artery disease, acute coronary syndrome, percutaneous coronary intervention, major adverse cardiac and cerebrovascular events, recurrent angina, refractory angina
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