Sažetak sa skupa

https://doi.org/10.15836/ccar2019.217

Characterization of patients with myocardial infarction with non-obstructive coronary arteries – experience from the Croatian branch of the ISACS-CT Registry

Ines Vinković1 orcid.org/0000-0003-1705-8295 ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Filip Lončarić ; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
Petra Mjehović ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Dorja Sabljak ; University of Zagreb School of Medicine, Zagreb, Croatia
Vedrana Vlahović ; University of Zagreb School of Medicine, Zagreb, Croatia
Vedrana Vlahović ; University of Zagreb School of Medicine, Zagreb, Croatia
Grgur Salai ; University of Zagreb School of Medicine, Zagreb, Croatia
Klara Klarić ; University of Zagreb School of Medicine, Zagreb, Croatia
Toni Radić ; University of Zagreb School of Medicine, Zagreb, Croatia
Saša Pavasović ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Nina Jakuš ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Dora Fabijanović ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Ivo Planinc ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Maja Čikeš ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
Davor Miličić ; University of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

Sažetak

Background and Aim: There are still wide knowledge gaps in myocardial infarction with non-obstructive coronary arteries (MINOCA) - a heterogeneous entity seen in 1-10% of patients with acute coronary
syndrome (ACS)1. The aim is to determine characteristics of MINOCA in the Croatian branch of the ISACS-CT registry, and compare them to age- and gender-matched patients with unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) and ST segment elevation myocardial infarction (STEMI).
Patients and Methods: The study included 2487 patients with ACS. MINOCA was defined by simultaneous cardiac troponin levels >0.014 ng/L, symptoms of ischemia or significant ST-T changes in the ECG,
and an absence of coronary artery stenosis of ≥ 50% on angiography. Age and gender-matching was performed from the remaining cohort by randomly sampling patients from the UA, STEMI and NSTEMI subgroups, based on the mean age ± 5 years and the gender ratio of the MINOCA group.
Results: MINOCA was seen in 2.5% (n=63) of the cohort, initially categorized as UA (37%), NSTEMI (48%) and STEMI (16%). Median age was 62 (53, 71) years, 56% male. After age- and gender-matching, there were 36 UA (10% of the UA cohort), 135 NSTEMI (15%) and 198 STEMI (16%) patients in the ACS control subgroups. MINOCA patients had a lower prevalence of diabetes, hypertension, dyslipidemia, chronic
kidney disease and tobacco use as compared to UA and NSTEMI. MINOCA patients used less antiplatelets, beta-blockers and statins before hospitalization. MINOCA and STEMI subgroups had a high incidence of chest pain symptoms and a short time from symptom onset to hospitalization. In the first 24h of hospitalization, less MINOCA patients were treated with antiplatelets and statins, and at discharge,
they were less frequently prescribed with antiplatelet drugs compared to UA and NSTEMI (Table 1). Inhospital mortality was low, with no deaths in MINOCA and UA patients, and 2 and 3 deaths in NSTEMI
and STEMI, respectively. Conclusion: MINOCA patients are mainly categorized as UA and NSTEMI at presentation, but have less
comorbidities, more pronounced symptoms of typical chest pain, a shorter time from symptoms to hospitalization, lower levels of statin and antiaggregation prescription at admission, and antiaggregation
at discharge. In-hospital mortality confirms MINOCA as low risk, however, long-term registry follow-up is needed to learn about longer term outcomes.

Ključne riječi

acute coronary syndrome; non-obstructive coronary disease

Hrčak ID:

226689

URI

https://hrcak.srce.hr/226689

Datum izdavanja:

15.10.2019.

Posjeta: 1.355 *