HealthDay News — Even the earlier signs of coronary artery disease (CAD) significantly increase the risk of myocardial infarction (MI) and early death, results of a study published in the Journal of the American Medical Association indicate.

Although non-obstructive CAD lesions occur in 10% to 25% of patients undergoing coronary angiography, their presence has been characterized as insignificant in medical literature.

“This perception of non-obstructive CAD may be incorrect, because prior studies have noted that the majority of plaque ruptures and resultant myocardial infarctions (MIs) arise from nonobstructive plaque,” explained Thomas Maddox, MD, of the VA Eastern Colorado Health Care System in Denver, and colleagues.

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To compare MI and mortality rates between patients with non-obstructive CAD, the researchers conducted a retrospective cohort study that included 37,674 patients.

Non-obstructive CAD significantly increased the risk of MI and death, found the investigators. A year after diagnosis, patients with non-obstructive coronary artery disease were about two to four and half times more likely to have suffered an MI or died with no apparent CAD.

“These findings suggest clinical importance of nonobstructive CAD and warrant further investigation of interventions to improve outcomes among these patients,” concluded the scientists.


  1. Maddox T et al. Journal of the American Medical Association. 2014; doi: 10.1001/jama.2014.14681