Cargando…

Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA)

Non-obstructive coronary artery disease occurs in 3.5–15% of patients presenting with acute myocardial infarction. This group of patients has a poor prognosis. Identification of factors that predict worse outcomes in myocardial infarction with non-obstructive coronary arteries (MINOCA) is therefore...

Descripción completa

Detalles Bibliográficos
Autores principales: Szolc, Piotr, Niewiara, Łukasz, Kleczyński, Paweł, Bryniarski, Krzysztof, Ostrowska-Kaim, Elżbieta, Szkodoń, Kornelia, Brzychczy, Piotr, Żmudka, Krzysztof, Legutko, Jacek, Guzik, Bartłomiej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501060/
https://www.ncbi.nlm.nih.gov/pubmed/36135431
http://dx.doi.org/10.3390/jcdd9090286
_version_ 1784795378021826560
author Szolc, Piotr
Niewiara, Łukasz
Kleczyński, Paweł
Bryniarski, Krzysztof
Ostrowska-Kaim, Elżbieta
Szkodoń, Kornelia
Brzychczy, Piotr
Żmudka, Krzysztof
Legutko, Jacek
Guzik, Bartłomiej
author_facet Szolc, Piotr
Niewiara, Łukasz
Kleczyński, Paweł
Bryniarski, Krzysztof
Ostrowska-Kaim, Elżbieta
Szkodoń, Kornelia
Brzychczy, Piotr
Żmudka, Krzysztof
Legutko, Jacek
Guzik, Bartłomiej
author_sort Szolc, Piotr
collection PubMed
description Non-obstructive coronary artery disease occurs in 3.5–15% of patients presenting with acute myocardial infarction. This group of patients has a poor prognosis. Identification of factors that predict worse outcomes in myocardial infarction with non-obstructive coronary arteries (MINOCA) is therefore important. Patients with a diagnosis of MINOCA (n = 110) were enrolled in this single-center, retrospective registry. Follow-up was performed 12, 24 and 36 months after discharge. The primary composite endpoint was defined as myocardial infarction, coronary revascularization, stroke or TIA, all-cause death, or hospital readmission due to any cardiovascular event. The mean age of the study group was 64.9 (± 13.5) years and 38.2% of patients were male. The occurrence of the primary composite endpoint was 36.4%. In a COX proportional hazards model analysis, older age (p = 0.027), type 2 diabetes (p = 0.013), history of neoplasm (p = 0.004), ST-segment depression (p = 0.018) and left bundle branch block/right bundle branch block (p = 0.004) by ECG on discharge, higher Gensini score (p = 0.022), higher intraventricular septum (p = 0.007) and posterior wall thickness increases (p = 0.001) were shown to be risk factors for primary composite endpoint occurrence. Our study revealed that several factors such as older age, type 2 diabetes, ST-segment depression and LBBB/RBBB in ECG on discharge, higher Gensini score, and myocardial hypertrophy and history of neoplasm may contribute to worse clinical outcomes in MINOCA patients.
format Online
Article
Text
id pubmed-9501060
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95010602022-09-24 Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA) Szolc, Piotr Niewiara, Łukasz Kleczyński, Paweł Bryniarski, Krzysztof Ostrowska-Kaim, Elżbieta Szkodoń, Kornelia Brzychczy, Piotr Żmudka, Krzysztof Legutko, Jacek Guzik, Bartłomiej J Cardiovasc Dev Dis Article Non-obstructive coronary artery disease occurs in 3.5–15% of patients presenting with acute myocardial infarction. This group of patients has a poor prognosis. Identification of factors that predict worse outcomes in myocardial infarction with non-obstructive coronary arteries (MINOCA) is therefore important. Patients with a diagnosis of MINOCA (n = 110) were enrolled in this single-center, retrospective registry. Follow-up was performed 12, 24 and 36 months after discharge. The primary composite endpoint was defined as myocardial infarction, coronary revascularization, stroke or TIA, all-cause death, or hospital readmission due to any cardiovascular event. The mean age of the study group was 64.9 (± 13.5) years and 38.2% of patients were male. The occurrence of the primary composite endpoint was 36.4%. In a COX proportional hazards model analysis, older age (p = 0.027), type 2 diabetes (p = 0.013), history of neoplasm (p = 0.004), ST-segment depression (p = 0.018) and left bundle branch block/right bundle branch block (p = 0.004) by ECG on discharge, higher Gensini score (p = 0.022), higher intraventricular septum (p = 0.007) and posterior wall thickness increases (p = 0.001) were shown to be risk factors for primary composite endpoint occurrence. Our study revealed that several factors such as older age, type 2 diabetes, ST-segment depression and LBBB/RBBB in ECG on discharge, higher Gensini score, and myocardial hypertrophy and history of neoplasm may contribute to worse clinical outcomes in MINOCA patients. MDPI 2022-08-26 /pmc/articles/PMC9501060/ /pubmed/36135431 http://dx.doi.org/10.3390/jcdd9090286 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Szolc, Piotr
Niewiara, Łukasz
Kleczyński, Paweł
Bryniarski, Krzysztof
Ostrowska-Kaim, Elżbieta
Szkodoń, Kornelia
Brzychczy, Piotr
Żmudka, Krzysztof
Legutko, Jacek
Guzik, Bartłomiej
Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA)
title Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA)
title_full Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA)
title_fullStr Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA)
title_full_unstemmed Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA)
title_short Clinical Characteristics Predicting Worse Long-Term Outcomes in Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA)
title_sort clinical characteristics predicting worse long-term outcomes in patients with myocardial infarction and non-obstructive coronary arteries (minoca)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501060/
https://www.ncbi.nlm.nih.gov/pubmed/36135431
http://dx.doi.org/10.3390/jcdd9090286
work_keys_str_mv AT szolcpiotr clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT niewiarałukasz clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT kleczynskipaweł clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT bryniarskikrzysztof clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT ostrowskakaimelzbieta clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT szkodonkornelia clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT brzychczypiotr clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT zmudkakrzysztof clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT legutkojacek clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca
AT guzikbartłomiej clinicalcharacteristicspredictingworselongtermoutcomesinpatientswithmyocardialinfarctionandnonobstructivecoronaryarteriesminoca