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Heart Disease Without Coronary Plaque Buildup Linked to Risk of Heart Attack

Non-obstructive CAD isn’t harmless, study shows

Non-obstructive coronary artery disease (CAD) was associated with a 28% to 44% increased risk of a major adverse cardiac event, such as a heart attack or death, in a new study presented at the American Heart Association’s Quality of Care and Outcomes Research 2014 Scientific Sessions, held June 2–4 in Baltimore, Maryland.

In this study, researchers evaluated 40,872 veterans who underwent elective cardiac angiography from October 2007 to September 2012. The patients’ condition was categorized as normal, non-obstructive CAD, or obstructive CAD. The rates of heart attack and death within 1 year after angiography increased progressively with increasing CAD severity, even among patients with non-obstructive CAD, the researchers found.

“Unlike obstructive CAD, which blocks blood flow, non-obstructive CAD may initially appear less threatening on angiography tests, but it appears to have significant risk for heart attack and death,” said lead investigator Thomas M. Maddox, MD, MSc, of the University of Colorado School of Medicine in Denver. “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.”

Preventative therapies include quitting smoking, healthy diets, getting enough exercise, losing weight, and taking preventative medications, such as aspirin and statins, the authors say.

Source: American Heart Association; June 4, 2014.

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