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.