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Treat MI patients without obstructive CAD for angina risk

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Heart attack patients without obstructive coronary artery disease should be “aggressively” treated to reduce the burden of angina, according to US researchers.

The call follows a study in which they found one in four patients were at a substantial risk of incurring residual angina following MI, even when they did not have CAD.

“Non-invasive strategies to reduce angina burden could have a significant impact of their health and quality of life”

Anna Grodzinsky

Such patients were also found to be just as likely to be re-admitted in the year following their heart attack as those who had coronary artery disease.

It is the first study to focus on the burden of residual angina after an initial heart attack and readmissions in patients without CAD versus with obstructive CAD.

The researchers noted that MI patients without obstructive CAD were known to be at increased risk for recurrent ischemic events, but angina frequency post-MI had not previously been identified.

They analysed data from 5,539 patients and 31 hospitals to investigate whether patients without obstructive CAD were as likely to have angina in the 12 months following their MI as those with obstructive CAD.

With 25% of patients without obstructive CAD found to report angina in the year following their initial heart attack, the study authors suggested that angina symptoms should be aggressively managed with the goal of improved outcomes.

“As these patients are not candidates for revascularization, other anti-anginal strategies are needed to improve their health status and quality of life,” said the study authors in the European Heart Journal - Quality of Care and Clinical Outcomes.

“Our findings highlight the importance of aggressive medical therapy and follow-up in patients with MI and no obstructive CAD”

Anna Grodzinsky

Lead author Dr Anna Grodzinsky, a fellow at Saint Luke’s Mid America Heart Institute in Missouri, said: “Our findings highlight the importance of aggressive medical therapy and follow-up in patients with MI and no obstructive CAD, in order to potentially reduce their burden of angina, improve the quality of life, and prevent re-hospitalisations.”

“Non-invasive strategies to reduce angina burden could have a significant impact of their health and quality of life,” she said.

She added: “Angina is a potentially modifiable condition and therefore patient symptoms could be improved, as well as healthcare costs.”

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