Clinical and instrumental indicators of acute myocardial infarction without coronary artery obstruction

Abstract

The frequency of myocardial infarction with non-obstructive coronary arteries (MINOCA) ranges from 5 to 11.1% in the structure of all myocardial infarctions. Left ventricular myocardial performance index (LV MPI) is the only echocardiographic independent predictor of unfavourable prognosis in patients with acute coronary syndrome. Purpose: to study risk factors for coronary heart disease, laboratory and echocardiographic indicators with the calculation of LV MPI in patients within the acute period of myocardial infarction. Material and methods. The study included 72 patients diagnosed with myocardial infarction. 40 patients had single-vessel coronary artery disease, 32 patients did not have stenosis > 50% according to coronary angiography. All patients underwent clinical examination, electrocardiography, clinical blood analysis and body chemistries. Echocardiography was performed on the first day of the disease. Results. A statistically significant difference among risk factors is hereditary load; in patients with MINOCA, it is the level of low-density lipoproteins and triglycerides. The glomerular filtration rate by CKD-Epi is lower by 17.6 ml/min (p = 0.0007). The LV ejection fraction, MPI is higher in patients with MINOCA (p = 0.001), in 3 patients (7.5%) who underwent percutaneous coronary intervention, LV MPI was 22.6%. Findings. 1. According to clinical signs, patients with MINOCA had a more severe course of the acute period. 2. Indicators of intracardiac hemodynamics are better in the group of patients with myocardial infarction, including the left ventricular myocardial performance index