Evidence map›Paper›PMID 27986756›Full record

SynthesisJournal of the American Heart Association2016

Nonobstructive Versus Obstructive Coronary Artery Disease in Acute Coronary Syndrome: A Meta-Analysis.

Carmine Pizzi, Borejda Xhyheri, Grazia Maria Costa, Massimiliano Faustino, Maria Elena Flacco, Maria Rosaria Gualano, Giorgia Fragassi, Francesco Grigioni, Lamberto Manzoli

Abstract readComparative StudyMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Higher anxiety score in patients with non-obstructive coronary artery disease.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2026
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  20. Optical coherence tomography in the diagnosis of myocardial infarction with non-obstructive coronary arteries.Postepy w kardiologii interwencyjnej = Advances in interventional cardiology · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Carmine PizziDepartment of Specialised, Experimental and Diagnostic Medicine, University of Bologna, Italy carmine.pizzi@unibo.it.
Borejda XhyheriDepartment of Specialised, Experimental and Diagnostic Medicine, University of Bologna, Italy.
Grazia Maria CostaDepartment of Specialised, Experimental and Diagnostic Medicine, University of Bologna, Italy.
Massimiliano FaustinoCardiology Department, Private Hospital "L. Pierangeli", Pescara, Italy.
Maria Elena FlaccoDepartment of Medicine, University of Chieti, Italy.
Maria Rosaria GualanoDepartment of Public Health Sciences, University of Turin, Torino, Italy.
Giorgia FragassiDepartment of Medicine, University of Chieti, Italy.
Francesco GrigioniDepartment of Specialised, Experimental and Diagnostic Medicine, University of Bologna, Italy.
Lamberto ManzoliLocal Health Unit of Pescara, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDifferences in prognosis and baseline clinical presentation have been documented among patient with acute coronary syndrome and coronary artery disease with obstructive (ObCAD) or nonobstructive arteries (NObCAD), but the rates of events largely varied across single studies. We carried out a meta-analysis to compare the clinical presentation and prognosis of NObCAD versus ObCAD acute coronary syndrome patients, as well as of the subjects with zero versus mild occlusion. METHODS AND

resultsSearches were made in MedLine, EMBASE, Cochrane databases, and proceedings of international meetings up to June 30, 2015. We compared the risk of events of NObCAD versus ObCAD patients using random-effect meta-analyses. We also performed meta-analyses to estimate the yearly or monthly outcome rates in each single group. In NObCAD and ObCAD patients, respectively, the combined yearly rates were as follows: 2.4% versus 10.1% (all-cause mortality); 1.2% versus 6.0% (myocardial infarction), 4.0% versus 12.8% (all-cause mortality plus myocardial infarction), 1.4% versus 5.9% (cardiac death), and 9.2% versus 16.8% (major cardiovascular events). In the studies directly comparing NObCAD versus ObCAD, all of the above outcomes were significantly less frequent in NObCAD subjects (with risk ratios ranging from 0.33 to 0.66). No differences in any outcome rate were observed between mild occlusion (1-49% stenosis) and zero occlusion patients.

conclusionsNObCAD in patients with acute coronary syndrome has a significantly lower cardiovascular risk at baseline and a subsequent lower likelihood of death or main cardiovascular events. However, these subjects are still at high risk for cardiovascular mortality and morbidity, suggesting potential undertreatment and calling for specific management.

Indexed as

Acute Coronary SyndromeCardiovascular DiseasesCoronary Artery DiseaseCoronary OcclusionFemaleHumansMalePrognosisRisk Factorsacute coronary syndromeacute myocardial infarctionangina pectoriscoronary artery diseaseepicardial vessel stenosismeta‐analysismicrocirculationnonobstructive coronary artery diseaseobstructive coronary artery diseaseprognosis

Identifiers

PMID27986756
PMCPMC5210396

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.