Table 3.
Predictors for absence of obstructive CAD in CAG in AIS patients with clinically suspected ACS
| All (n) = 114 | Missing values (n) | CAD absent n = 27 (24%) |
CAD n = 87 (76%) |
p value | Unadjusted OR (95% CI) |
|---|---|---|---|---|---|
| Female, % (n) | 0 | 41% (11) | 29% (25) | 0.315 | 0.59 (0.24–1.44) |
| Age, years | 0 | 68 (58 to 75) | 75 (68 to 81) | 0.008 | 0.95 (0.92–0.99) |
| Age ≥ 75 y, % (n) | 0 | 19% (5) | 47% (41) | 0.008 | 0.26 (0.09–0.74) |
| Stroke characteristics | |||||
| NIHSS, median (IQR) | 1 | 5 (2 to 11) | 3 (1 to 6) | 0.024 | 1.08 (1.01–1.16) |
| Ischemic insular cortex lesion, % (n) | 0 | 44% (12) | 13% (11) | 0.001 | 5.53 (2.06–14.84) |
| Thrombolysis, % (n) | 0 | 44% (12) | 18% (16) | 0.008 | 3.55 (1.40–9.02) |
| Lacunar vs non lacunar (TOAST), % (n) | 1 | 4% (1) | 3% (3) | 0.950 | 1.06 (0.11–10.67) |
| Cardio embolic vs non-cardio embolic (TOAST), % (n) | 1 | 49% (13) | 40% (35) | 0.467 | 1.38 (0.58–3.29) |
| Time onset to CAG in d, median (IQR) | 0 | 3.7 (2.0 to 6.0) | 3.9 (2.5 to 8.0) | 0.305 | 1.02 (0.98–1.07) |
| Cardiac findings (non-invasive) | |||||
| WMA (echo/CAG), % (n) | 1 | 35% (9) | 63% (55) | 0.010 | 0.31 (0.12–0.77) |
| LVEF in %, median (IQR) | 5 | 63.5 (42.3 to 73.2) | 50.0 (30.0 to 60.0) | 0.016 | 1.03 (1.01–1.06) |
| LVEF ≥ 40%, % (n) | 5 | 78% (21) | 64% (56) | 0.200 | 2.02 (0.69–5.95) |
| ECG, signs of ischemia, % (n) | 0 | 26% (7) | 39% (34) | 0.213 | 0.55 (0.21–1.43) |
| Clinical symptoms, % (n) | 2 | 7% (2) | 29% (25) | 0.033 | 0.19 (0.04–0.87) |
| Scores | |||||
| Killip-class, median (IQR) | 1 | 1 (1 to 1) | 1 (1 to 2) | 0.066 | 0.27 (0.07–1.09) |
| GRACE-score, median (IQR) | 9 | 99 (73 to 116) | 118 (97 to 133) | 0.022 | 0.98 (0.96–1.00) |
| CRUSADE-score, median (IQ R) | 11 | 29 (25 to 35) | 35 (24 to 45) | 0.114 | 0.97 (0.93–1.01) |
| HEART-score, median (IQR) | 9 | 4 (3 to 4) | 5 (4 to 6) | 0.001 | 0.61 (0.45–0.83) |
| Laboratory measurements | |||||
| hsTnT admission in ng/l, median (IQR) | 5 | 51 (25 to 146) | 43 (17 to 99) | 0.666 | 1.00 (1.00–1.00) |
| Peak hsTnT (before CAG) in ng/l, median (IQR) | 4 | 146 (56 to 513) | 121 (40 to 417) | 0.688 | 1.00 (1.00–1.00) |
| hsTnT dynamic change (before CAG) in %, median (IQR) | 11 | 12.7 (− 6.3 to 235.9) | 10.3 (− 6.7 to 129.8) | 0.860 | 1.00 (1.00–1.00) |
| Peak CK in U/l, median (IQR) | 6 | 139 (86 to 382) | 177 (101 to 376) | 0.766 | 1.00 (1.00–1.00) |
| NTproBNP in ng/l, median (IQR) | 89 | 1459 (1196 to 3240) | 3945 (814 to 7020) | 0.860 | 1.00 (1.00–1.00) |
| CRP in mg/l, median (IQR) | 1 | 4.2 (1.9 to 16.0) | 5.0 (3.0 to 12.7) | 0.687 | 1.00 (0.99–1.01) |
| HbA1c in %, median (IQR) | 12 | 5.7 (5.4 to 6.0) | 6.1 (5.7 to 6.8) | 0.182 | 0.73 (0.46–1.16) |
| Cardiovascular risk factors | |||||
| Number of CVRF, median (IQR) | 2 | 2 (1 to 2) | 2 (2 to 3) | 0.002 | 0.48 (0.30–0.76) |
| CVRF n > 2, % (n) | 2 | 19% (5) | 46% (40) | 0.012 | 0.26 (0.09–0.74) |
| Hypertension, % (n) | 0 | 67% (18) | 86% (75) | 0.026 | 0.32 (0.12–0.88) |
| Diabetes mellitus, % (n) | 0 | 15% (4) | 38% (33) | 0.032 | 0.29 (0.09–0.90) |
| Smoking current, % (n) | 0 | 22% (6) | 43% (37) | 0.063 | 0.39 (0.14–1.05) |
| Hyperlipidemia, % (n) | 2 | 56% (15) | 98% (85) | 0.334 | 0.65 (0.27–1.56) |
| AF, % (n) | 0 | 26% (7) | 23% (20) | 0.754 | 1.17 (0.43–3.17) |
| History of stroke, % (n) | 0 | 11% (3) | 26% (23) | 0.109 | 0.35 (0.10–1.27) |
| Prior known CAD, % (n) | 0 | 3.7% (1) | 27.6% (24) | 0.009 | 0.10 (0.01–0.79) |
| Previous medication | |||||
| Antiplatelet, % (n) | 3 | 26% (7) | 48% (44) | 0.026 | 0.34 (0.13–0.90) |
| Oral anticoagulation, % (n) | 3 | 4% (1) | 12% (10) | 0.237 | 0.30 (0.04–2.46) |
| Betablocker, % (n) | 6 | 20% (5) | 18% (16) | 0.845 | 1.12 (0.36–3.45) |
| Statin, % (n) | 3 | 23% (6) | 38% (32) | 0.171 | 0.50 (0.18–1.37) |
| Vital signs | |||||
| BPsys admission in mmHg, median (IQR) | 9 | 143 (129 to 171) | 155 (138 to 176) | 0.461 | 0.99 (0.98–1.01) |
| BPdia admission in mmHg, median (IQR) | 9 | 80 (62 to 93) | 80 (71 to 97) | 0.927 | 1.00 (0.98–1.02) |
| HR in bpm, median (IQR) | 2 | 71 (71 to 76) | 71 (71 to 89) | 0.233 | 0.98 (0.95–1.01) |
CAD coronary artery disease, NIHSS National Institutes of Health Stroke Scale, CAG coronary angiography, d days, WMA wall motion abnormalities, LVEF left ventricular ejection fraction, ECG electrocardiogram, CVRF cardiovascular risk factors, AF atrial fibrillation, BPsys systolic blood pressure, BBdia diastolic blood pressure, HR heart rate, bpm beats per minute