In patients with coronary artery ectasia, MINOCA presentation was associated with a higher incidence of major adverse cardiovascular events (16.3% vs. 4.2%, P = 0.045).
Does presentation with MINOCA predict worse outcomes compared to INOCA/ANOCA in patients with coronary artery ectasia and nonobstructive coronary artery disease?
In patients with coronary artery ectasia and nonobstructive CAD, presenting with MINOCA rather than INOCA/ANOCA is an independent predictor of future major adverse cardiovascular events.
Absolute Event Rate: 0% vs 0%
Aims Coronary artery ectasia (CAE) has been linked to the occurrence of adverse events in patients with ischemia/angina and no obstructive coronary arteries (INOCA/ANOCA), while the relationship between CAE and myocardial infarction with nonobstructive coronary arteries (MINOCA) has been poorly investigated. In our study we aimed at assessing differences in clinical, angiographic and prognostic features among patients with CAE and MINOCA vs. INOCA/ANOCA presentation. Methods Patients with angiographic evidence of CAE were enrolled at the University Hospital of Parma and divided into MINOCA vs. INOCA/ANOCA presentation. Clinical and quantitative angiographic information was recorded and the incidence of major adverse cardiovascular events (MACE) was assessed at follow-up. Results We enrolled a total of 97 patients: 49 (50.5%) with MINOCA and 48 (49.5%) with INOCA/ANOCA presentation. The presentation with MINOCA was associated with a higher frequency of inflammatory diseases ( P = 0.041), multivessel CAE ( P = 0.030) and thrombolysis in myocardial infarction (TIMI) flow < 3 ( P = 0.013). At a median follow-up of 38 months, patients with MINOCA had a significantly higher incidence of MACE compared with those with INOCA/ANOCA 8 (16.3%) vs. 2 (4.2%), P = 0.045, mainly driven by a higher rate of nonfatal MI 5 (10.2%) vs. 0 (0.0%), P = 0.023. At multivariate Cox regression analysis, the presentation with MINOCA ( P = 0.039) and the presence of TIMI flow <3 ( P = 0.037) were independent predictors of MACE at follow-up. Conclusion Among a cohort of patients with CAE and nonobstructive coronary artery disease, the presentation with MINOCA predicted a worse outcome.
Gurgoglione et al. (Fri,) reported a other. In patients with coronary artery ectasia, MINOCA presentation was associated with a higher incidence of major adverse cardiovascular events (16.3% vs. 4.2%, P = 0.045).