Approximately half of patients with signs or symptoms of ischemia referred for coronary angiogram are found to have nonobstructive coronary artery disease.
When comparing individuals who apparently have a normal coronary artery system with their counterparts with nonobstructive coronary artery disease the latter have worse outcomes.
In the study of 38,000 veterans, the presence of nonobstructive coronary artery disease on coronary angiography is associated with a higher mortality at one year compared with those with normal coronary arteries.
A Danish study 11,000 subjects with angina with a first coronary angiogram showing nonobstructive coronary artery disease associated with a high risk adverse outcomes at 7 1/2 years median follow up.
In the above study heart failure and cardiovascular mortality are the adverse findings.
A meta-analysis of 64,000 patients evaluated with CT coronary angiogram or invasive coronary angiography with nonobstructive coronary artery disease findings, compared with those with normal angiograms, there was a threefold higher risk of major adverse cardiac events at 27 months median follow up.
Symptomatic individuals with nonobstructive coronary artery disease have similar health care costs and disabilities as those with obstructive coronary artery disease, mostly as a result of repeated hospitalizations for heart failure and angina.
Most patients with nonobstructive coronary heart disease have preserved left ventricular ejection fraction, but are still more prone to hospitalization for heart failure.