Key result
MINOCA patients are younger, more often female, and have higher smoking and hypertension versus obstructive MI.
Why the study?
A comparative characterization of myocardial infarction with and without obstructive coronary artery lesions was needed to understand demographic, clinical, and laboratory differences.
Observational (n=4,639)
Yes
Patients with MINOCA have a distinct clinical and demographic profile compared to those with obstructive coronary artery disease, being significantly younger and more frequently female.
Supports considering MINOCA in younger women with MI and risk factors; leaves open etiology-specific interventions.
Objective: to give a comparative characterization of myocardial infarction with and without obstructive lesion of coronary arteries. Material and Methods. The study involved 4639 patients included in the first total register of acute coronary syndrome in the Krasnodar Territory for the first 12 months of register operation. A comparative analysis of patients with myocardial infarction with obstructive lesion and without obstructive lesion of coronary arteries was performed. Results. Between November 2016 and November 2017, 4453 patients with myocardial infarction with obstructive coronary disease, including 2261 men (50.8%) and 2192 women (49.2%) were enrolled in the register. The mean age of patients was 68.3±12.03 years (69.3±3.42 years in men; 63.4±7.35 years in women). The criteria for myocardial infarction without obstructive coronary artery disease were present in 186 people (4.1%), including 72 men (38.7%) and 114 women (72.3%). The average age of the patients was 54.2±4.53 years; age of men with myocardial infarction without obstructive coronary disease was 56.3±3.52 years; age of women was 52.1±3.12 years. The article presents a detailed comparative analysis of demographic, medical history, clinical-instrumental, and laboratory data of these patient groups. Conclusion. Compared with patients who had obstructive coronary changes, the cohort of patients with myocardial infarction without obstructive lesions of the coronary arteries was younger and included more female patients; among the risk factors in this group, smoking and arterial hypertension were significant; the rates of newly diagnosed diabetes mellitus and Q-positive myocardial infarction were higher. According to the analysis of echocardiographic data, significant decrease in global contractility of the left ventricular myocardium was less common; analysis of laboratory data showed that patients more often had low platelet count.
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Кручинова et al. (2019) conducted an observational in Myocardial infarction (n=4,639). Myocardial infarction without obstructive lesion of coronary arteries vs. Myocardial infarction with obstructive lesion of coronary arteries was evaluated on Demographic, medical history, clinical-instrumental, and laboratory characteristics. Patients with myocardial infarction without obstructive coronary lesions were younger, more often female, and had higher rates of smoking and hypertension compared to those with obstructive lesions.
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