Key result
MINOCA carries substantial 1-year cardiovascular risk compared with obstructive MI and non-cardiovascular controls.
Why the study?
While 1-year mortality for MINOCA has been reported, rates for other cardiovascular events have not yet been systematically studied in sufficiently large real-world populations.
What is the 1-year prognosis for cardiovascular outcomes in patients with MINOCA compared to patients with obstructive MI-CAD and controls without apparent cardiovascular disease?
Cohort
Yes
What is the 1-year prognosis for cardiovascular outcomes in patients with MINOCA compared to patients with obstructive MI-CAD and controls without apparent cardiovascular disease?
Answers are grounded in this paper and cite their sources.
Evaluates the 1-year cardiovascular prognosis of patients with MINOCA compared to obstructive MI and non-CVD controls in a large nationwide Swedish registry, demonstrating that MINOCA is not a benign condition.
Introduction: Around 10% of patients with myocardial infarction (MI) does not have significant coronary stenoses, so called MI with non-obstructed coronary arteries (MINOCA). A meta-analysis by Pasupathy reported a 1-year mortality of 3.5% for MINOCA, but rates for other cardiovascular (CV) events have not yet systematically been studied in sufficiently large real-world populations. Purpose: To determine the 1-year prognosis for different CV outcomes in patients with MINOCA (coronary stenosis <50%) and to compare with MI patients with significant (≥50%) coronary stenosis (MI-CAD) and patients without apparent CV disease. Methods: Registry-based cohort study (SWEDEHEART) using data from patients admitted between 2009 and 2013 to hospitals in Sweden. Patients with previous MI or previous coronary interventions were excluded. Patients without significant (<50%) coronary stenoses at angiography, with a peak cardiac troponin T level <14 ng/L, and discharged without a specified CV diagnosis were used as a control group. Information on 1-year outcome was obtained from mandatory national registries. The prognostic importance of MINOCA was evaluated in multivariable-adjusted Cox models.
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Hjort et al. (2017) conducted a cohort in Myocardial infarction with non-obstructive coronary arteries (MINOCA). Myocardial infarction with non-obstructive coronary arteries (MINOCA, coronary stenosis <50%) vs. MI with significant (≥50%) coronary stenosis (MI-CAD) and controls without apparent CV disease (stenosis <50%, peak cardiac troponin T <14 ng/L, no specified CV diagnosis) was evaluated on 1-year cardiovascular outcomes. Myocardial infarction with non-obstructive coronary arteries (<50% stenosis) is not a benign disorder compared to obstructive MI (≥50% stenosis) and non-CV controls over 1 year in SWEDEHEART.
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