Incidence and prognosis of myocardial infarction with non-obstructive coronary arteries (MINOCA)

IF 2.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2025-01-01 DOI:10.1016/j.acvd.2024.10.089

I. Chamtouri , W. Jomaa , A. Turki , K. Ben Hamda

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引用次数: 0

Abstract

Introduction

Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a heterogeneous entity often overlooked in contemporary medicine. Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a heterogeneous entity often overlooked in contemporary medicine.

Objective

To assess incidence and characteristics of MINOCA in a large cohort of patients admitted for myocardial infarction.

Method

A total of 1734 consecutive patients were retrospectively enrolled in the STEMI registry of the cardiology B department of Fattouma Bourguiba university. MINOCA was defined as a non-obstructive coronary artery disease and a lack of previous coronary revascularization. Clinical profile and prognosis of all patients were assessed.

Results

The proportion of MINOCA patients among all myocardial infarction was 2.7%. The MINOCA patients were younger (age 47 ± 14.9 vs. 60.7 ± 12.4 years), more often males (87.2% vs. 78.7%) with significantly lower rates of diabetes mellitus (19.1% vs. 36.4%, p = 0.015), hypertension (10.6% vs. 30.6%, p = 0.003), kidney disease (2.1% vs. 7.8%, p = 0.032), peripheral artery disease (2.8% vs. 8.3%, p = 0.015) and previous MI (2.1% vs. 11.1%, p = 0.028) comparing to patients with obstructive coronary artery disease (CAD). History of smoking was more common in the MINOCA group. Typical chest pain at presentation was higher in MINOCA patients (98.6% vs. 93,4%, p = 0.046). MINOCA patients presented more frequently anterior ST- segment elevation. All-cause in-hospital and 5 years follow-up mortality rate was lower in the MINOCA patients (1.5% vs. 9.6%, p < 0.001; 7.6 vs. 13.8%, p = 0.036 respectively).

Conclusion

MINOCA represents a challenging group of heterogeneous patients whose clinical characteristics contrast with classical cardiovascular risk factors. A search for etiology and eventual treatment provides a rich avenue for improving prognosis in patients with MINOCA.

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.