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

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...

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Autores principales: Gasior, Pawel, Desperak, Aneta, Gierlotka, Marek, Milewski, Krzysztof, Wita, Krystian, Kalarus, Zbigniew, Fluder, Joanna, Kazmierski, Maciej, Buszman, Paweł E., Gasior, Mariusz, Wojakowski, Wojciech
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564426/
https://www.ncbi.nlm.nih.gov/pubmed/32867273
http://dx.doi.org/10.3390/jcm9092779
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author Gasior, Pawel
Desperak, Aneta
Gierlotka, Marek
Milewski, Krzysztof
Wita, Krystian
Kalarus, Zbigniew
Fluder, Joanna
Kazmierski, Maciej
Buszman, Paweł E.
Gasior, Mariusz
Wojakowski, Wojciech
author_facet Gasior, Pawel
Desperak, Aneta
Gierlotka, Marek
Milewski, Krzysztof
Wita, Krystian
Kalarus, Zbigniew
Fluder, Joanna
Kazmierski, Maciej
Buszman, Paweł E.
Gasior, Mariusz
Wojakowski, Wojciech
author_sort Gasior, Pawel
collection PubMed
description 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.
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spelling pubmed-75644262020-10-26 Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry Gasior, Pawel Desperak, Aneta Gierlotka, Marek Milewski, Krzysztof Wita, Krystian Kalarus, Zbigniew Fluder, Joanna Kazmierski, Maciej Buszman, Paweł E. Gasior, Mariusz Wojakowski, Wojciech J Clin Med Article 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. MDPI 2020-08-27 /pmc/articles/PMC7564426/ /pubmed/32867273 http://dx.doi.org/10.3390/jcm9092779 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gasior, Pawel
Desperak, Aneta
Gierlotka, Marek
Milewski, Krzysztof
Wita, Krystian
Kalarus, Zbigniew
Fluder, Joanna
Kazmierski, Maciej
Buszman, Paweł E.
Gasior, Mariusz
Wojakowski, Wojciech
Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry
title Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry
title_full Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry
title_fullStr Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry
title_full_unstemmed Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry
title_short Clinical Characteristics, Treatments, and Outcomes of Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Results from a Multicenter National Registry
title_sort clinical characteristics, treatments, and outcomes of patients with myocardial infarction with non-obstructive coronary arteries (minoca): results from a multicenter national registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564426/
https://www.ncbi.nlm.nih.gov/pubmed/32867273
http://dx.doi.org/10.3390/jcm9092779
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