Clinical Characteristics and In-Hospital Prognosis of Myocardial Infarction With Nonobstructive Coronary Arteries in a Single-Center Experience


YILANCIOĞLU R. Y., Başkurt A. A., ÖZPELİT E., BADAK Ö., AKDENİZ B.

Catheterization and Cardiovascular Interventions, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1002/ccd.70302
  • Dergi Adı: Catheterization and Cardiovascular Interventions
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Anahtar Kelimeler: MINOCA, myocardial injury, nonobstructive coronary arteries, prevalence, risk factors
  • Dokuz Eylül Üniversitesi Adresli: Evet

Özet

Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous syndrome presenting as acute infarction despite < 50% epicardial stenosis. Recognition remains low, and optimal management is unclear. Aims: This study aims to analyze the clinical profile of MINOCA patients compared to those with myocardial infarction with obstructive lesions, and evaluate MINOCA patients. Methods: A total of 1421 consecutive patients with acute MI admitted to our hospital between January 2016 and March 2019 were retrospectively screened. Patients were classified into two groups: MINOCA, comprising patients with no significant lesions on angiography, and MI-CAD, consisting of patients with lesions of the coronary artery. A total of 130 patients with MINOCA and 210 patients with MI-CAD were enrolled. Demographics, laboratory parameters, imaging findings, etiologies, in-hospital outcomes, and discharge therapies were analyzed. Results: The prevalence of MINOCA was 9.7%. Patients with MINOCA were more frequently women (especially premenopausal women) and had a younger age (54.65 ± 18.4 to 63.2 ± 12.3, p < 0.001). The prevalence of traditional CAD risk factors was lower in MINOCA patients. Patients with MINOCA were more likely to have a history of upper-respiratory-tract infections (URIs) and use of antidepressant drugs compared to MI-CAD at admission. In-hospital mortality and event rates were comparable to those with MI-CAD. However, antiplatelets, statins, renin−angiotensin system blockers, and β-blockers were less frequently prescribed to patients with MINOCA at discharge. Conclusions: Patients with MINOCA constitute a population that differs from the classical MI profile. Compared with MI-CAD, MINOCA is accompanied by fewer traditional risk factors for CAD.