<abstract xmlns="http://www.w3.org/1999/xhtml">

<italic><bold>Background:</bold></italic> Coronary artery tortuosity (CAT) is a frequently encountered angiographic feature of patients with ischemia and non-obstructive coronary arteries (INOCA). However, there is limited data regarding the possible correlation between CAT and all-cause mortality in these patients.
<italic><bold>Aim:</bold></italic> To assess the survival prognostic implications of CAT in INOCA patients and the predictors of all-cause mid-term mortality of these patients.
<italic><bold>Methods:</bold></italic> All consecutive INOCA patients, with preserved ejection fraction evaluated for clinical ischemia by coronary angiography in our department between January 2014 and December 2020 were considered for inclusion. Patients with epicardial coronary artery stenosis ≥ 50%, severe pulmonary hypertension, or decompensated extra cardiac disease were excluded.
Eleid classification was used for CAT severity characterization.
We assessed all-cause mortality in January 2023.
<italic><bold>Results:</bold></italic> Our sample included 328 INOCA patients. 15.54% died during the mean follow-up of 3.75 ± 1.32 years. 79.88% had CAT. CAT patients were older (65.10±9.09 versus 61.24±10.02 years, p=0.002), and more often female (67.18% versus 31.82%, p&lt;0.001).
CAT was inversely correlated with all-cause mid-term mortality (OR 0.35, 95%CI 0.16 – 0.77, p=0.01). CAT severity had no impact on survival.
In CAT patients the initial multivariable analysis identified NT-proBNP levels (HR 3.96, p=0.01), diabetes mellitus (DM) (HR 4.76, p=0.003), and atrial fibrillation (HR 2.68, p=0.06) as independent predictors of all-cause mortality. In the final analysis, NT-proBNP and DM were the main independent predictors of survival.
<italic><bold>Conclusions</bold></italic>: In our INOCA cohort, CAT patients were older and more likely female. CAT was inversely correlated with mid-term all-cause mortality. NT-proBNP and DM were the main independent predictors of mortality of CAT patients.
</abstract>

Background: Coronary artery tortuosity (CAT) is a frequently encountered angiographic feature of patients with ischemia and non-obstructive coronary arteries (INOCA). However, there is limited data regarding the possible correlation between CAT and all-cause mortality in these patients.
Aim: To assess the survival prognostic implications of CAT in INOCA patients and the predictors of all-cause mid-term mortality of these patients.
Methods: All consecutive INOCA patients, with preserved ejection fraction evaluated for clinical ischemia by coronary angiography in our department between January 2014 and December 2020 were considered for inclusion. Patients with epicardial coronary artery stenosis ≥ 50%, severe pulmonary hypertension, or decompensated extra cardiac disease were excluded.
Eleid classification was used for CAT severity characterization.
We assessed all-cause mortality in January 2023.
Results: Our sample included 328 INOCA patients. 15.54% died during the mean follow-up of 3.75 ± 1.32 years. 79.88% had CAT. CAT patients were older (65.10±9.09 versus 61.24±10.02 years, p=0.002), and more often female (67.18% versus 31.82%, p<0.001).
CAT was inversely correlated with all-cause mid-term mortality (OR 0.35, 95%CI 0.16 – 0.77, p=0.01). CAT severity had no impact on survival.
In CAT patients the initial multivariable analysis identified NT-proBNP levels (HR 3.96, p=0.01), diabetes mellitus (DM) (HR 4.76, p=0.003), and atrial fibrillation (HR 2.68, p=0.06) as independent predictors of all-cause mortality. In the final analysis, NT-proBNP and DM were the main independent predictors of survival.
Conclusions: In our INOCA cohort, CAT patients were older and more likely female. CAT was inversely correlated with mid-term all-cause mortality. NT-proBNP and DM were the main independent predictors of mortality of CAT patients.

Coronary artery tortuosity and mid-term all-cause mortality of patients with ischemia and non-obstructive coronary arteries

“Carol Davila” University of Medicine and Pharmacy

Romanian Journal of Internal Medicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background: Coronary artery tortuosity (CAT) is a frequently encountered angiographic feature of patients with ischemia and non-obstructive coronary arteries...

Coronary artery tortuosity and mid-term all-cause mortality of patients with ischemia and non-obstructive coronary arteries

Published Online: Aug 04, 2023

Page range: 202 - 211

Received: Jul 24, 2023

DOI: https://doi.org/10.2478/rjim-2023-0019

Keywords
non-obstructive coronary arteries, coronary artery tortuosity, all-cause mortality

© 2023 Dumitru Emilian Mihai et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Coronary artery tortuosity and mid-term all-cause mortality of patients with ischemia and non-obstructive coronary arteries

Published Online: Aug 04, 2023

Page range: 202 - 211

Received: Jul 24, 2023

DOI: https://doi.org/10.2478/rjim-2023-0019

Keywordsnon-obstructive coronary arteries, coronary artery tortuosity, all-cause mortality

© 2023 Dumitru Emilian Mihai et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
non-obstructive coronary arteries, coronary artery tortuosity, all-cause mortality