Impact of sex on the follow-up course and predictors of clinical outcomes in patients hospitalised due to myocardial infarction with non-obstructive coronary arteries: a single-centre experience.

BACKGROUND

Myocardial infarction with non-obstructive coronary arteries (MINOCA) occurs more often in women.

AIM

We sought to assess the relationship between sex and clinical outcomes during follow-up in patients after MINOCA and to identify predictors of major adverse cardiac and cerebrovascular events (MACCE).

METHODS

The study comprised 134 patients (78 women) at the mean age of 61.6 years, who were diagnosed with MINOCA at the Department of Cardiology between January 2015 and June 2018. The mean follow-up duration was 609.5 ± 412.2 days. Pri-mary study endpoints were MACCE, which included all-cause death, myocardial infarction, reintervention, and cerebral stroke. Secondary endpoints were recurrent chest pain during follow-up and rehospitalisation for reasons other than MACCE.

RESULTS

Kaplan-Meier survival curve analysis did not reveal any significant differences in the frequency of MACCE (p = 0.63) or mortality rate (p = 0.29) between men and women. There was no significant impact of sex on secondary study endpoints either. Sex was not identified as a predictor of primary or secondary study endpoints in univariate or multivariate analysis. Troponin index (risk ratio [RR] 1.002; 95% confidence interval [CI] 1.0005-1.0026, p = 0.004), age (RR 1.04; 95% CI 1.008-1.065, p = 0.01), serum creatinine level (RR 1.01; 95% CI 1.001-1.01, p = 0.02), hyperlipidaemia (RR 0.26; 95% CI 0.07-0.75, p = 0.01), and prior venous thromboembolic disease (RR 8.28; 95% CI 1.15-38, p = 0.04) were found to be predictors of MACCE in multivariate analysis.

CONCLUSIONS

Sex was not found to be significantly associated with clinical outcomes during the follow-up period in patients with MINOCA.