Clinical Characteristics and In‐Hospital Prognosis of Myocardial Infarction With Nonobstructive Coronary Arteries in a Single‐Center Experience

Background Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous syndrome presenting as acute infarction despite < 50% epicardial stenosis. Recognition remains low, and optimal management is unclear. Aims This study aims to analyze the clinical profile of MINOCA patients compared to those with myocardial infarction with obstructive lesions, and evaluate MINOCA patients. Methods A total of 1421 consecutive patients with acute MI admitted to our hospital between January 2016 and March 2019 were retrospectively screened. Patients were classified into two groups: MINOCA, comprising patients with no significant lesions on angiography, and MI‐CAD, consisting of patients with lesions of the coronary artery. A total of 130 patients with MINOCA and 210 patients with MI‐CAD were enrolled. Demographics, laboratory parameters, imaging findings, etiologies, in‐hospital outcomes, and discharge therapies were analyzed. Results The prevalence of MINOCA was 9.7%. Patients with MINOCA were more frequently women (especially premenopausal women) and had a younger age (54.65 ± 18.4 to 63.2 ± 12.3, p < 0.001). The prevalence of traditional CAD risk factors was lower in MINOCA patients. Patients with MINOCA were more likely to have a history of upper‐respiratory‐tract infections (URIs) and use of antidepressant drugs compared to MI‐CAD at admission. In‐hospital mortality and event rates were comparable to those with MI‐CAD. However, antiplatelets, statins, renin−angiotensin system blockers, and β‐blockers were less frequently prescribed to patients with MINOCA at discharge. Conclusions Patients with MINOCA constitute a population that differs from the classical MI profile. Compared with MI‐CAD, MINOCA is accompanied by fewer traditional risk factors for CAD.