Wellens Syndrome: Single Centre Study and Literature Review

Abstract

Abstract Background Wellens syndrome is a clinical, biological, and electrocardiographic complex that identifies a subgroup of patients with unstable angina who have an impending risk of myocardial infarction and death, representing an equivalent of ST segment elevation myocardial infarction. Methods We conducted a prospective analysis of 64 consecutive patients, recruited over 2 years, with Wellens syndrome who underwent coronary angiography and we compared them with an age- and sex-matched group of patients with non-ST segment elevation acute coronary syndrome who underwent coronary angiography. The primary endpoints of our study were the rate of cardiovascular rehospitalizations, the rate of ischaemic reccurences, the rate of subsequent or recurrent revascularization, and the rate of mortality at six months from the index event. Results At 6 months, the patients in the control group had a higher rate of cardiovascular rehospitalizations (41.9% vs. 21.9%, p = 0.016). The rate of ischaemic recurrences and the rate of global mortality were similar across the two groups. Conclusion Physiopathologically and angiographically, Wellens syndrome is an abortive form of ST segment elevation myocardial infarction, but electrocardiographically and prognostically, it evolves similarly to a non-ST segment elevation acute coronary syndrome.