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. 2020 Aug 27;9(9):2779.
doi: 10.3390/jcm9092779.

Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry

Pawel Gasior  1 , Aneta Desperak  2 , Marek Gierlotka  3 , Krzysztof Milewski  4 , Krystian Wita  5 , Zbigniew Kalarus  6 , Joanna Fluder  1 , Maciej Kazmierski  1 , Paweł E Buszman  7 , Mariusz Gasior  2 , Wojciech Wojakowski  1
Affiliations

Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry

Pawel Gasior et al. J Clin Med. .

Abstract

Background: Diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA) requires both clinical evidence of acute myocardial infarction (AMI) and demonstration of non-obstructive coronary arteries using angiography. We compared the clinical features, treatments, and three-year outcomes in patients with MINOCA and myocardial infarction with obstructive coronary artery disease (MI-CAD).

Methods: We retrospectively analyzed data for 205,606 hospitalized patients with AMI. MINOCA was indicated as a working diagnosis in 6063 patients (2.94% of all AMI patients). For the control group we included 160,886 patients with MI-CAD. We evaluated the baseline characteristics, medication management options, outcomes, and readmission causes at 36 months follow-up.

Results: Patients in the MINOCA group were younger. Females constituted a greater proportion of patients in the MINOCA group when compared to MI-CAD patients. STEMI during admission was diagnosed less frequently in the MINOCA group when compared to the MI-CAD group. All-cause mortality at 12 months was higher in the MINOCA group (10.94% vs. 9.54%, p < 0.001). At 36 months, there was no difference in the all-cause mortality rates (MINOCA 16.18% vs. MI-CAD 14.93%, p = 0.081). All-cause readmission rates were lower in the MINOCA group when compared to the MI-CAD group at both 12 months (45.19% vs. 54.33%, p < 0.001) and 36 months follow-up (56.42% vs. 66.66%, p < 0.001).

Conclusions: This is the first description of the clinical features, treatments, and three-year outcomes in a large population of Polish patients. The main finding of this study was a relatively low rate of MINOCA, with high rates of adverse events both at 12 and 36 months follow-up.

Keywords: MINOCA; NSTEMI; STEMI.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart. (A) Minoca group flowchart (B) MI-CAD flowchart. AMI = acute myocardial infarction, MI = myocardial infarction, PCI = percutaneous coronary intervention, CABG = coronary artery bypass grafting, MINOCA = myocardial infarction with non-obstructive coronary arteries, MI-CAD = myocardial infarction with obstructive coronary artery disease.
Figure 2
Figure 2
The 1-year Kaplan–Meier events rates. Kaplan–Meier curves show the cumulative incidence rates of (A) death and (B) myocardial infarction.
Figure 3
Figure 3
Multivariate analysis results. (A) 12 months results. (B) 36 months results.
See this image and copyright information in PMC

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