Information and opinions presented here do not always represent the views of the American Heart Association.

Non-obstructive coronary artery disease may be more threatening than it seems

Published: 4:17 pm CDT, June 4, 2014

Non-obstructive coronary artery disease was associated with a 28 to 44 percent increased risk of a major 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.

Researchers observed 40,872 veterans who underwent elective cardiac angiography from October 2007 to September 2012.  Angiography is an X-ray test that can detect weakened blood vessel walls and narrowed or blocked vessels. Patients were categorized as having normal, non-obstructive or obstructive CAD. Heart attack and death rates within a year of angiography increased with CAD severity, even among those patients with non-obstructive CAD, researchers found.

In this study, non-obstructive CAD was defined as blood vessels that were less than 70 percent blocked.

“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 Thomas M. Maddox, M.D., M.Sc., the study’s lead researcher, a cardiologist for the VA Eastern Colorado Health Care System and associate professor of medicine at 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.”

Patients with non-obstructive disease should ask their physicians about preventative therapies, like quitting smoking, healthy diets, getting enough exercise, losing weight and taking preventative medications such as aspirin and statins.

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