Unraveling the Multitude of Etiologies in Myocardial Infarction With Nonobstructive Coronary Arteries
Section snippets
Methods
We performed a retrospective analysis of data from a large, prospective observational study in patients with acute coronary syndrome (ACS). All consecutive adult patients admitted with ACS to the Isala hospital (Zwolle, The Netherlands) between January 2006 and December 2014 were included. The design of this study has been published previously.2 Patients were subdivided into either single-vessel obstructive ACS (SV-ACS), multivessel obstructive ACS (MV-ACS), or MINOCA. Patients with MINOCA were
Results
The database consisted of 9,198 patients with ACS. After exclusion of cases with missing data on crucial parameters (as described previously2), 7,693 patients remained eligible. Of these, 3,266 had SV-ACS (43%) and 4,025 MV-ACS (52%), whereas 402 patients (5%) were diagnosed with MINOCA. Finally, 355 patients with MINOCA remained for further analysis because no working or differential diagnosis could be retrieved in 47 cases (12%) which were excluded from further analysis. Five MINOCA subgroups
Discussion
The current analysis focused on long-term prognosis of the different subgroups of MINOCA based on the underlying diagnosis. The cardiomyopathy group showed poorest survival rates (73%), even worse compared with SV-ACS and MV-ACS. Secondly, the “indeterminate” subgroup also showed a relatively poor prognosis, with a more pronounced decrease in survival after approximately 5 years following index hospitalization. This is in line with previous research which also found the cardiomyopathy subgroup
Disclosures
The authors have no conflicts of interest to declare.
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Drs. Pustjens and Dr. Vranken contributed equally to this work.