Nonobstructive Plaque Buildup Linked with Increased Heart Attack Risk

According to the results of a recent study, patients with nonobstructive coronary artery disease (CAD) may be at an increased risk for heart attack and all-cause mortality.

The study, published in the November 5, 2014, issue of the Journal of the American Medical Association, evaluated the risks of adverse cardiac events among patients with obstructive, nonobstructive, or no CAD. The researchers of the study analyzed data from US veterans undergoing elective coronary angiography CAD between 2007 and 2012. Patients who had previously suffered CAD events were excluded from the analysis.

Among 37,674 veterans, 8384 (22.3%) had nonobstructive CAD and 20,899 (55.4%) had obstructive CAD. After 1 year, 854 patients with CAD died and 385 were rehospitalized for a heart attack. After adjusting for other variables, the results indicated that as the extent of CAD increased, the risk for heart attack also increased. Patients with nonobstructive CAD were approximately 2 to 4.5 times more likely to experience a heart attack or die than those with no apparent CAD, depending on the severity of CAD.

“These findings suggest clinical importance of nonobstructive CAD and warrant further investigation of interventions to improve outcomes among these patients,” the study authors wrote.