Rodriguez-Capitan, JorgeSanchez-Perez, AndresBallesteros-Pradas, SaraMillan-Gomez, MercedesCardenal-Piris, RosaOneto-Fernandez, ManuelGutierrez-Alonso, LolaRivera-Lopez, RicardoGuisado-Rasco, AgustinCano-Garcia, MacarenaGutierrez-Bedmar, MarioJimenez-Navarro, Manuel2023-02-092023-02-092021-04-22Rodríguez-Capitán J, Sánchez-Pérez A, Ballesteros-Pradas S, Millán-Gómez M, Cardenal-Piris R, Oneto-Fernández M, et al. Prognostic Implication of Non-Obstructive Coronary Lesions: A New Classification in Different Settings. J Clin Med. 2021 Apr 25;10(9):1863.2077-0383http://hdl.handle.net/10668/17704The clinical significance of non-obstructive coronary artery disease is the subject of debate. Our objective was to evaluate the long-term cardiovascular prognosis associated with non-obstructive coronary artery disease in patients undergoing coronary angiography, and to conduct a stratification by sex, diabetes, and clinical indication. We designed a multi-centre retrospective longitudinal observational study of 3265 patients that were classified into three groups: normal coronary arteries (lesion <20%, 1426 patients), non-obstructive coronary artery disease (20–50%, 643 patients), and obstructive coronary artery disease (>70%, 1196 patients). During a mean follow-up of 43 months, we evaluated a combined cardiovascular event: acute myocardial infarction, stroke, hospitalization for heart failure, or cardiovascular death. Multivariable-adjusted Cox proportional hazard models showed a worse prognosis in patients with non-obstructive coronary artery disease, in comparison with patients of normal coronary arteries group, in the total population (hazard ratio 1.72, 95% confidence interval 1.23–2.39; p for trend <0.001), in non-diabetics (hazard ratio 2.12, 95% confidence interval: 1.40–3.22), in women (hazard ratio 1.75, 95% confidence interval 1.10–2.77), and after acute coronary syndrome (hazard ratio 2.07, 95% confidence interval 1.25–3.44). In conclusion, non-obstructive coronary artery disease is associated with an impaired long-term cardiovascular prognosis. This association held for non-diabetics, women, and after acute coronary syndrome.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/acute coronary syndromecoronary angiographycoronary artery diseasediabetes mellitussexCoronary Artery DiseaseCoronary AngiographyAcute Coronary SyndromeRetrospective StudiesFollow-Up StudiesProportional Hazards ModelsClinical RelevanceConfidence IntervalsMyocardial InfarctionHeart FailureStrokeDiabetes MellitusPrognosisHospitalizationresearch article33923110open accessAccidente cerebrovascularAngiografía coronariaDiabetes mellitusEnfermedad de la arteria coronariaEstudios retrospectivosEstudios de seguimientoInfarto del miocardioInsuficiencia cardíacaIntervalos de confianzaModelos de riesgos proporcionalesPronósticoRelevancia clínicaSíndrome coronario agudo10.3390/jcm10091863PMC8123418https://www.mdpi.com/2077-0383/10/9/1863/pdf?version=1619400339https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8123418/pdf