Clinical characteristics and prognosis of myocardial infarction with non-obstructive coronary arteries

Abstract

Objective: To investigate the clinical features and prognosis in myocardial infarction patients with non-obstructive coronary arteries (MINOCA). Methods: The data were obtained from consecutive patients with acute myocardial infarction (AMI) hospitalized in the First Affiliated Hospital of Dalian Medical University from January 2005 to October 2016. The coronary angiography (CAG) showed that the coronary artery of the AMI patients was normal or near normal (<50% stenosis). The general clinical conditions and prognosis were analyzed. Composite endpoints included all-cause death, myocardial reinfarction, and re-admission to hospital for angina. Results: There were 5 474 patients diagnosed with AMI undergoing CAG examination during this 11 years. Among them, 139 cases were with MINOCA (2.5%). The age of the patients with MINOCA was (55.8±12.2) years, and most of them were men (69.1%). Among them, 52.5% (73 cases) were with hypertension, 43.2% (60 cases) were smoker, 9.4% (13 cases) were with diabetes, respectively. There are a variety of causes, however, 64.0% (89 cases) patients were with unclear etiology. After 1 year followed-up, 3 cases (2.2%) suffered death, 3 cases (2.2%) were developed to nonfatal myocardial reinfarction and 8.6% (12 cases) were re-admitted to hospital for angina. Conclusions: The prevalence of MINOCA is relatively low. Hypertension and smoking are the main risk factors. Patients are relatively young and most of them are male.