MINOCA: HYPERTENSION IS NOT AN IMPORTANT RISK FACTOR

Abstract

Objective: We studied the epidemiological, clinical and prognostic profile of the MINOCA population then compared them to patients with obstructive coronary artery disease and finally we established an etiological analysis of the MINOCA population. Design and method: Descriptive prospective study spread over a period of 36 months from January 2018 to January 2021 involving a total number of 585 patients undergoing coronary angiography at the cardiology department of CHU Tlemcen for a reason for acute myocardial ischemia. We defined the patients as having acute myocardial ischemia with obstructive coronary artery disease (AMI-CO) if there was revascularization or plaque > 50% and as having MINOCA if there was < 50% obstruction or a mechanism without plaque. Patients who did not have coronary angiography or who received thrombolytics before angiography were excluded.® Results: Of 585 patients undergoing angiography, 525 (89.74%) had AMI-CO, 60 (10.25%) had a MINOCA. Men were 4 times more likely to have MINOCA than women (78.3% versus 21.7%; odds ratio at 3.61). MINOCA patients were more likely to be without traditional cardiac risk factors (7.9% vs. 2.1%; P < 0.001) but more predisposed to non-traditional risk factors than AMI-CO patients (3.7% against 1.8%; P = 0.026). Smoking is the only traditional risk factor frequent in the MINOCA population versus AMI-CO (P at 0.001). Hypertension is not an important risk factor for MINOCA (38% versus 51%; P = 0.066). Depression, stress, drug addiction, DVT history and autoimmune disease history are more frequent in the MINOCA population versus AMI-CO (P < 0.05). STEMI are more found in the MINOCA population versus AMI-CO (P = 0.001). In terms of prognosis, the MINOCA population had a better prognosis: less risk of recurrence than the AMI-CO population 6.7% versus 10.45% (P = 0.03) also less mortality 0% versus 2.3% (P = 0.237). Conclusions: The patients with MINOCA were more men, smokers, depressed, stressed, drug addicts with hypercoagulable states compared to patients with obstructive coronary artery disease (AMI-CO) however they had a better quality of life and a good prognosis.