ST ELEVATION ACUTE CORONARY SYNDROME IN NON-OBSTRUCTIVE LESION OF CORONARY ST ELEVATION ACUTE CORONARY SYNDROME IN NON-OBSTRUCTIVE LESION OF CORONARY ARTERIES: DATA FROM THE REGISTRY RECORD-3

Material and methods. The data used, from the acute coronary syndrome registry RECORD-3, in the emergency cardiology department of Tomsk SRI of Cardiology, together with another 51 center in Russia. Based on the absence of presence of NOCA, patients with ST elevation myocardial infarction, who had undergone coronary arteriography, were selected to two independent groups: 27 with NOCA and 571 with OCA.

Results. There were no significant differences in the clinical portrait of NOCA and OCA patient. However, palpitation followed angina attack in NOCA patients. In the NOCA, there was significantly lower number of persons with diagnostically relevant raise of cardio specific enzymes. Indirectly, it points on temporary ischemia with no necrosis, or that the area of necrotic myocardium is not large. In NOCA patients, statistically more significantly were absent reciprocal ECG changes. Endpoints as mortality and novel heart failure development had tendency to statistically more significant decrease of prevalence in NOCA patients. As final diagnosis at discharge, in NOCA patients more often another diagnosis was mentioned (including unstable angina, etc.), but not myocardial infarction. The key issues in hospital management of these two groups were identical, except more often prescription of dihydropiridine calcium channel blockers to NOCA patients, and rarer prescription of antiplatelet drugs at discharge.

Conclusion. Regardless the fact that prognosis in ACS with NOCA and intact arteries is better than in OCA, it is necessary to analyze thoroughly pathogenesis of the disease in every case, as in this category of patients especially, it is most heterogenic. As these patients have comorbid factors, it is necessary to select the leading one, and to intensify efforts on this factor directly.

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