Patients with MINOCA exhibited similar endogenous thrombin potential compared to those with obstructive coronary artery disease (1,590 vs 1,750 nM/min, p=0.55), suggesting comparable prothrombotic tendencies.
Case-Control (n=50)
No
Do patients with MINOCA have a greater prothrombotic tendency compared to patients with MICAD?
MINOCA patients exhibit similar thrombin generation potential and thrombophilia profiles compared to MICAD patients at 1 month post-MI, suggesting comparable prothrombotic tendencies.
Absolute Event Rate: 1590% vs 1750%
p-value: p=0.55
Abstract Patients presenting with myocardial infarction (MI) in the absence of obstructive coronary artery disease (CAD) is termed MI with nonobstructive coronary arteries (MINOCA). The underlying pathophysiology of MINOCA is multifactorial and in situ formation and subsequent spontaneous lysis of a coronary thrombus is often hypothesized as one of the mechanisms. The objective of this study is to determine whether MINOCA patients had a greater prothrombotic tendency in comparison to MI patients with obstructive CAD (MICAD). Prospectively, blood samples of 25 consecutive MINOCA patients (58 (interquartile range IQR: 48, 75) years, 48% women) and 25 age-/gender-matched MICAD patients (58 (IQR: 50, 66) years, 48% women) were obtained at 1 month after the initial presentation and overall thrombin generation potential and congenital/acquired thrombophilia states were assessed. As regard to results, overall thrombin generation parameters were similar (p > 0.05) between the MINOCA and MICAD groups, highlighting similar endogenous thrombin potential (1,590 nM/min; IQR: 1,380, 2,000 vs. 1,750 nM/min; IQR: 1,500, 2,040, respectively). There were no significant differences between MINOCA and MICAD, respectively, in respect to the numbers of patients with congenital thrombophilia states including factor V Leiden (0 vs. 4%) and prothrombin gene mutation (8 vs. 4%), decreased antithrombin (8 vs. 0%), protein C (0 vs. 0%), and protein S (4 vs. 0%). None of the patients demonstrated presence of lupus anticoagulant and anticardiolipin antibodies. Although MINOCA patients revealed thrombotic characteristics that are similar to those with MICAD, the results from this study are inconclusive and a larger study with healthy control subjects is required to assess the risk of thrombosis in MINOCA.
Pasupathy et al. (2018) conducted a case-control in Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA) (n=50). Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA) vs. Myocardial Infarction with Obstructive Coronary Artery Disease (MICAD) was evaluated on Endogenous thrombin potential (ETP) (p=0.55). Patients with MINOCA exhibited similar endogenous thrombin potential compared to those with obstructive coronary artery disease (1,590 vs 1,750 nM/min, p=0.55), suggesting comparable prothrombotic tendencies.