Results of dynamic Follow-Up for Patients with Myocardial Infarction without Obstructive Lesion of Coronary Arteries: Data of the Overall Register for Acute Coronary Syndrome in Krasnodar Region

Abstract

Background Myocardial infarction (MI) without obstructive lesion of coronary arteries (MINOCA) has incidence to 14%. Despite its high prevalence, MINOCA is paid not enough attention, therefore some patients can not receive appropriate treatment. Aim Evaluating the long-term results of clinical observation in patients with MINOCA in comparison with patients with obstructive damage and the subsequent revascularization of myocardium. Material On the basis of Scientific Research Institute RCH – 1 the multicenter cohort observation was organized. Patients from the register CROCS (the register of acute coronary syndrome in Krasnodar Region) with the diagnosis MI were divided into two groups: MINOCA including patients without obstructive damage of coronary arteries and MINOCA including patients with obstructive injury and the subsequent stenting a heart attack connected artery. All patients in 12 months would have control assessment during which they had objective survey; electrocardiography; daily monitoring; test of six-minute walking, echocardiography. Results In the MINOCA group in 12 months after the acute coronary event in 21.5% cases there were tension stenocardia, in 16.2% – a painless form of myocardial ischemia was revealed, in a group of patients with MINOCA stenocardia of tension was revealed at 12.5% and 8.4% – with painless ischemia. The group of patients with MINOCA is characterized by more reliable decrease in both parameters of heart rate variability, and turbulence of heart rate. MINOCA is followed by statistically significant increase in risk of ACS development and death within 12 months. All indicators had reliable difference. Conclusion Patients with MINOCA are a special group, their differential characteristics demand definite diagnostic efforts.