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One-Year Prognosis Difference of Myocardial Infarction With or Without Coronary Obstruction in Developing Countries:
Amine Bouchlarhem1,2, Ihssane Merimi1,2, Zakaria Bazid1,2
1Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco.
Insights
Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) have a better prognosis than those with Myocardial Infarction with Coronary Artery Disease (MI-CAD). MINOCA patients experienced lower rates of mortality and acute events over one year.
Area of Science:
- Cardiology
- Clinical Medicine
- Cardiovascular Research
Background:
- Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) diagnosis presents diagnostic challenges.
- The comparative prevalence of mortality and acute events between MINOCA and Myocardial Infarction with Coronary Artery Disease (MI-CAD) remains debated.
Purpose of the Study:
- To compare the clinical and prognostic characteristics of MINOCA patients versus MI-CAD patients.
- To evaluate 1-year all-cause mortality and a composite of 1-year readmission for myocardial infarction or acute heart failure as primary and secondary outcomes.
Main Methods:
- A 2-year retrospective study of patients admitted for Acute Coronary Syndrome (ACS).
- Analysis of 1077 patients, categorizing them into MINOCA (4.7%) and MI-CAD (95.3%) groups.
- Statistical comparison of baseline characteristics and 1-year outcomes, including mortality and readmission rates.
Main Results:
- Significant differences observed in age, hypertension, diabetes, and ejection fraction between MINOCA and MI-CAD groups.
- MINOCA patients demonstrated a significantly better prognosis.
- Adjusted hazard ratios indicated lower 1-year mortality (HR=0.601), ACS readmission (HR=0.662), and AHF readmission (HR=0.539) in MINOCA patients.
Conclusions:
- Despite etiological uncertainties, MINOCA patients exhibit a favorable short- and long-term prognosis.
- MINOCA is associated with significantly better outcomes compared to MI-CAD.
Introduction:
The debate remains open as to the difference in prevalence of mortality and occurrence of acute events in patients with Myocardial infarction with non-obstructive coronary arteries (MINOCA) and others with Myocardial infarction with coronary arteries disease (MI-CAD).
Methods:
We conducted a 2-year retrospective study for patients admitted for Acute coronary syndrome (ACS) to analyze the clinical and prognostic characteristics of patients with MINOCA versus MI-CAD. We defined 1-year all-cause mortality as the primary outcome, and the secondary outcome as a composite of 1-year readmission for myocardial infarction or acute heart failure (AHF).
Results:
Our study included 1077 patients, 95.3% with MI-CAD and 4.7% with MINOCA. At admission, 71.1% patient were diagnosed STEMI and 28.9% with NSTEMI. The difference between the 2 groups was found on age (P < .001), hypertension, diabetes with consecutive P-values of .007 and .001, as well as Ejection fraction (P < .001). For the outcomes studied, the difference was significant between the 2 groups for all events, and MINOCA patients had a better prognosis than MI-CAD patients, with adjusted hazard ratios (HR) for 1-year mortality (HR = 0.601 P = .004), for readmission for ACS (HR = 0.662; P = .002) and for readmission for AHF (HR = 0.539; P = .019).
Conclusion:
Despite the ambiguity in the genesis of MINOCA, the short- and long-term prognosis of these patients remains generally favorable.
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