OBJETIVO: Avaliar as características clínicas, a evolução e as complicações intra-hospitalares de pacientes com síndromes coronarianas agudas (SCA) na ausência de doença arterial coronariana (DAC) obstrutiva significativa. MÉTODOS: Estudo transversal envolvendo pacientes internados, de agosto/96 a março/02, com síndromes coronarianas agudas, com e sem supradesnivelamento ST, analisando as características clinicas, demográficas e complicações intra-hospitalares nos casos com (>50%) e sem (< 50%) estenose coronariana significativa. RESULTADOS: Dos 1351 pacientes admitidos com síndrome coronariana aguda, 28% apresentavam supradesnivelamento ST e 72% não o demonstravam. Os pacientes com a síndrome coronariana aguda sem supradesnivelamento do segmento ST, na ausência de obstrução coronariana significativa, eram mais jovens, predominantemente mulheres, e apresentavam menor freqüência de dislipidemia, doença arterial coronariana prévia, diabetes mellitus, tabagismo e hipertensão arterial sistêmica, quando comparados àqueles com lesão obstrutiva significativa. Entre os indivíduos com síndrome coronariana aguda e supradesnivelamento ST, tabagismo foi o fator de risco com maior prevalência nos pacientes com lesão obstrutiva não significativa. Quanto às complicações, houve menor freqüência de isquemia recorrente, insuficiência cardíaca congestiva e arritmias em pacientes com síndrome coronariana aguda sem supradesnivelamento ST na ausência de lesão coronariana obstrutiva significativa. CONCLUSÃO: Pacientes com síndrome coronariana aguda sem supradesnivelamento ST com lesões coronarianas obstrutivas não significativas são mais jovens, predominantemente mulheres, com menor freqüência de fatores de risco para doença arterial coronariana e menor incidência de complicações, em relação aos pacientes com lesão coronariana obstrutiva significativa.
OBJECTIVE: To assess the clinical characteristics, evolution, and in-hospital complications of patients with acute coronary syndromes (ACS) in the absence of significant obstructive coronary artery disease (CAD). METHODS: Cross-sectional study of patients hospitalized from August 1996 to March 2002 with acute coronary syndrome, with or without an elevation in the ST segment, and with (= 50%) or without (<50%) significant coronary stenosis. Their clinical and demographic characteristics and their in-hospital complications were analyzed. RESULTS: Of the 1351 patients admitted with acute coronary syndrome, 28% had an elevation in the ST segment and 72% had no elevation. The patients with acute coronary syndrome with no elevation in the ST segment and no significant coronary obstruction were younger, predominantly females, and had a lower frequency of dyslipidemia, previous coronary arterial disease, diabetes mellitus, smoking, and systemic arterial hypertension, when compared with those with significant obstructive lesion. Among the individuals with acute coronary syndrome and an elevation in the ST segment, smoking was the most prevalent risk factor in patients with nonsignificant obstructive lesion. In regard to complications, recurring ischemia, congestive heart failure, and arrhythmias were more frequent in patients with acute coronary syndrome with no elevation in the ST segment and no significant obstructive coronary lesion. CONCLUSION: Patients with acute coronary syndrome with no elevation in the ST segment and with nonsignificant obstructive coronary lesions are younger, predominantly females, have a greater frequency of risk factors for coronary arterial disease, and a lower incidence of complications as compared with patients with significant obstructive coronary lesion.
