Clinical Features and Long-Term Outcomes in Very Young Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries

Juan-Salvadores, Pablo; Díaz, Víctor Jiménez; Araujo, Ana Rodríguez González de; Carreño, Cristina Iglesia; González, Alba; Veiga, César; Alonso, José Antonio Baz; Caamaño-Isorna, Francisco; Romo, Andrés Íñiguez

doi:10.1155/2022/9584527

Cited by 8 publications

(3 citation statements)

References 40 publications

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“…The study also found associations between poor outcomes in the MINOCA population and cocaine use (HR 14.58, 95% CI 3.08-69.02), family history (HR 6.20, 95% CI 1.40-27.43), and depression (HR 5.16, 95% CI 1.06-25.24). However, their study had a different design compared to ours, as it lacked an elderly control group [17]. A subgroup analysis of the Kaplan-Meier survival analysis of the groups.…”

Section: Discussionmentioning

confidence: 86%

Long-term outcomes in very young patients with myocardial infarction with non-obstructive coronary arteries

Ipek,

Nural,

Cebeci

et al. 2024

Coronary Artery Disease

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Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) covers an expanding group of patients over recent years. Previous studies showed considerable risks of outcomes in this group. However, there is a lack of evidence in young patients with MINOCA. In this study, we aimed to investigate the long-term outcomes in very young patients with MINOCA. We retrospectively compared the features and predictors of 183 very young (≤40-year-old) patients to >40-year-old patients with MINOCA. We compared the baseline characteristics and major adverse cardiac events (total MI, revascularization and mortality) rates between the groups during a median follow-up of 7.3 years. We performed the Cox regression analysis to investigate the risk factors for mortality. We found that the ≤40-year-old group with MINOCA had 12% mortality rates during the follow-up. They had significantly lower rates of diabetes and hypertension and higher rates of male gender and smoking compared to the older group. The very young group also had lower rates of CRF, previous MI and atrial fibrillation. The ≤40-year-old groups received significantly lower rates of medications. Ejection fraction (EF) <30% was independently associated with 6-fold increases in total mortality [hazard ratio (HR) = 6.23, 95% confidence interval (CI) 1.42–27.2, P = 0.02] in the ≤40-year-old group. In conclusion, the ≤40-year-old patients with MINOCA have substantial long-term mortality rates. EF <30% was independently associated with total mortality in this group. Moreover, the ≤40-year-old group also received less intense medical therapy compared to their older counterparts.

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Section: Discussionmentioning

confidence: 86%

Long-term outcomes in very young patients with myocardial infarction with non-obstructive coronary arteries

Ipek,

Nural,

Cebeci

et al. 2024

Coronary Artery Disease

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“…References: [14][15][16][17][18][19][20][21][22][24][25][26][27][28] MIOCA: myocardial infarction with obstructive coronary arteries; MINOCA: myocardial infarction with nonobstructive coronary arteries…”

Section: Figure 5: All-cause Mortalitymentioning

confidence: 99%

Comparison of Long-Term Outcomes of Patients With Myocardia Infarction (MI) With Non-obstructive Coronary Arteries and MI With Obstructive Coronary Arteries: A Systematic Review and Meta-Analysis

Naeem,

Khan,

Gergess

et al. 2023

Cureus

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The aim of this study was to compare long-term outcomes in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) and patients with myocardial infarction with obstructive coronary arteries (MIOCA). This meta-analysis was conducted according to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The literature search was conducted in online databases including PubMed and Web of Science from 2010 onwards. Primary outcomes assessed in this meta-analysis included major adverse cardiovascular events (MACE) and all-cause mortality. Secondary outcomes included cardiovascular mortality and myocardial infarction. A total of 16 studies were included in the meta-analysis. Pooled analysis showed that the risk of MACE was higher in MIOCA patients (risk ratio (RR): 1.47, 95%CI: 1.43-1.52, p-value: 0.001) compared to MINOCA patients. Additionally, the risk of all-cause mortality was also significantly higher in MIOCA patients compared to MINOCA (RR: 1.33, 95%CI: 1.14-1.56, p-value: 0.001). Our findings also indicate that patients with MIOCA are at a significantly higher risk of recurrent myocardial infarction and cardiovascular-related mortality compared to patients with MINOCA. Overall, the insights gained from this meta-analysis have significant clinical implications, guiding decision-making in the management of patients with MINOCA.

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“…Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a disease characterized by clinical signs of a myocardial infarction with normal or near-normal coronary arteries on angiography (stenosis <50%) [1,2]. The most prevalent cause of acute coronary syndrome (ACS) is atherosclerotic plaque formation caused by erosion.…”

Section: Introductionmentioning

confidence: 99%

Clinical Features and Long-Term Outcomes in Very Young Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries

Ullah¹,

Ahmad²,

Adeel³

et al. 2023

PJMHS

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Background and Aim: The most common cause of acute coronary syndrome (ACS) is the erosion causing the development of atherosclerotic plaque. There is, however, a subset of individuals with ACS-like symptoms but no significant coronary artery obstruction characterized as myocardial infarction with non-obstructive coronary arteries (MINOCA). The purpose of the present study was to assess the clinical features and long-term outcome of young MI patients with non-obstructive coronary arteries. Patients and Methods: This prospective observational study was carried out on 926 patients underwent coronary angiographies in the Cardiology Department of Medical Teaching Institute (MTI) Lady Reading Hospital, Peshawar from January 2019 to December 2022. All the patients (age ≤45 years) with suspected acute coronary syndrome were enrolled. Participants were categorized into three groups: Group-I [obstructive coronary artery disease (o-CAD)], Group-II (MINOCA diagnosed patients), and Group-III [control (non-coronary artery disease)]. Demographic details, clinical features, and outcomes of patients were recorded. Results: Of the total 926 patients underwent coronary angiographies, about 122 (13.2%) patients were ≤45 years old. Out of 122 patients, the incidence of o-CAD, MINOCA, and control (non-coronary artery disease) was 60.7% (n=74), 13.1% (n=16), and 26.2% (n=32) respectively. Chest pain was the most prevalent symptom found in 95.1% (n=116) group-I, 93.8% (n=15) in group-II, and 81.3% (n=26) respectively. MINOCA patients had similar high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels with o-CAD patients, however, the triglyceride values was significantly higher (180.8±90.6) than control (136.2±82.8). Conclusion: The present study found that MINOCA and o-CDA group patients had similar long-term poor outcomes. Triglyceride levels, depression, BMI >30 kg/m2, and family history of CAD are significant risk factors for MINOCA during follow-up. Secondary preventive initiatives are required in these patients to avoid recurrences and enhance outcomes. Keywords: CAD, MINOCA, Young patients, Clinical features, Long-term outcomes

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Clinical Features and Long-Term Outcomes in Very Young Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries

Cited by 8 publications

References 40 publications

Long-term outcomes in very young patients with myocardial infarction with non-obstructive coronary arteries

Long-term outcomes in very young patients with myocardial infarction with non-obstructive coronary arteries

Comparison of Long-Term Outcomes of Patients With Myocardia Infarction (MI) With Non-obstructive Coronary Arteries and MI With Obstructive Coronary Arteries: A Systematic Review and Meta-Analysis

Clinical Features and Long-Term Outcomes in Very Young Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries

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