Clinical significance and prevalence of normal coronary angiography in patients with acute coronary syndrome

The purpose of the study was a retrospective analysis of the prevalence of normal coronary angiography in patients with acute coronary syndrome (ACS) and further outcome assessment. Material and methods: 913 emergency coronary angiographies were performed for suspected ACS between 2006 and 2007. 12-month follow-up was conducted. Results: No coronary atherosclerotic changes were found in 76 (8.3%) out of 913 ACS patients with non Q-wave MI patients being prevalent. The diagnosis was confirmed by cardiac biomarker elevation in 22% of cases. ACS patients with normal coronaries tend to have more favourable inhospital and 1-year outcomes compared with atherosclerosis patients. Gastroenterology disorders were significantly more often diagnosed in patients with normal coronaries. Conclusions. The result of the study, on the one hand, proves the possibility of ischemic heart disease development, ACS in particular, in patients with normal coronaries, and, on the other hand, demonstrates the need for more accurate consideration of all the ACS criteria to exclude other probable reasons for chest pain.