TY - JOUR
T1 - MINOCA
T2 - The caveat of absence of coronary obstruction in myocardial infarction
AU - Vranken, Nousjka P. A.
AU - Pustjens, Tobias F. S.
AU - Kolkman, Evelien
AU - Hermanides, Renicus S.
AU - Bekkers, Sebastiaan C. A. M.
AU - Smulders, Martijn W.
AU - van Cauteren, Yvonne J. M.
AU - Heijman, Jordi
AU - Rasoul, Saman
AU - Ottervanger, Jan P.
AU - van't Hof, Arnoud W. J.
PY - 2020/8
Y1 - 2020/8
N2 - Aims: Whether patients with MINOCA (myocardial infarction with non-obstructive coronary arteries) have better outcomes than patients with obstructive coronary artery disease remains contradictory. The current study focussed on the clinical profile and prognosis of MINOCA patients.Methods and results: We performed a retrospective analysis of patients with acute coronary syndrome (ACS) admitted to the Isala hospital in Zwolle, the Netherlands, between 2006 and 2014. A total of 7693 patients were categorized into three groups: MINOCA, single-vessel obstructive ACS (SV-ACS), and multi-vessel obstructive ACS (MV-ACS). MINOCA patients (5.2% of the total population) were more likely to be female (51.5% vs. 30.3% and 26.0% in SV-ACS and MV-ACS, respectively, p <0.001 for both). The prevalence of risk factors in the MINOCA group was in between the SV-ACS and MV-ACS groups. Logistic regression revealed a lower odds of dying in SV-ACS (odds ratio (OR) = 0.70 (p = 0.04)) and a similar odds in MV-ACS (OR = 0.88, p = 0.45) compared to MINOCA.Conclusions: Patients with MINOCA show an 'intermediate' risk profile with mortality rates in between those of both ACS groups. Hence, MINOCA should be recognised as a potential risk factor for mortality, requiring adequate treatment and follow-up. (C) 2020 The Authors. Published by Elsevier B.V.
AB - Aims: Whether patients with MINOCA (myocardial infarction with non-obstructive coronary arteries) have better outcomes than patients with obstructive coronary artery disease remains contradictory. The current study focussed on the clinical profile and prognosis of MINOCA patients.Methods and results: We performed a retrospective analysis of patients with acute coronary syndrome (ACS) admitted to the Isala hospital in Zwolle, the Netherlands, between 2006 and 2014. A total of 7693 patients were categorized into three groups: MINOCA, single-vessel obstructive ACS (SV-ACS), and multi-vessel obstructive ACS (MV-ACS). MINOCA patients (5.2% of the total population) were more likely to be female (51.5% vs. 30.3% and 26.0% in SV-ACS and MV-ACS, respectively, p <0.001 for both). The prevalence of risk factors in the MINOCA group was in between the SV-ACS and MV-ACS groups. Logistic regression revealed a lower odds of dying in SV-ACS (odds ratio (OR) = 0.70 (p = 0.04)) and a similar odds in MV-ACS (OR = 0.88, p = 0.45) compared to MINOCA.Conclusions: Patients with MINOCA show an 'intermediate' risk profile with mortality rates in between those of both ACS groups. Hence, MINOCA should be recognised as a potential risk factor for mortality, requiring adequate treatment and follow-up. (C) 2020 The Authors. Published by Elsevier B.V.
KW - ACS/NSTE-ACS
KW - ARTERY-DISEASE
KW - CARDIOVASCULAR MAGNETIC-RESONANCE
KW - Clinical research
KW - MINOCA
KW - STE-ACS
KW - DISEASE
KW - GUIDELINES
KW - ARTERIES MINOCA
KW - POSITION PAPER
U2 - 10.1016/j.ijcha.2020.100572
DO - 10.1016/j.ijcha.2020.100572
M3 - Article
C2 - 32642553
SN - 2352-9067
VL - 29
JO - IJC Heart & Vasculature
JF - IJC Heart & Vasculature
M1 - 100572
ER -