非阻塞性冠状动脉心肌梗死患者中冠状动脉痉挛诱发的急性心肌梗死
Coronary artery spasm-induced acute myocardial infarction in patients with myocardial infarction with non-obstructive coronary arteries.
作者信息
Sueda Shozo, Sakaue Tomoki
机构信息
Department of Cardiology, Ehime Prefectural Niihama Hospital, Hongou 3 choume 1-1, Niihama City, Ehime Prefecture, 792-0042, Japan.
Department of Cardiology, Yawatahama City General Hospital, Yawatahama, Japan.
出版信息
Heart Vessels. 2021 Dec;36(12):1804-1810. doi: 10.1007/s00380-021-01878-z. Epub 2021 Jul 2.
Coronary artery spasm-induced acute myocardial infarction (CASIAMI) is one of the etiologies of myocardial infarction with non-obstructive coronary arteries (MINOCA). We retrospectively analyzed the incidence and clinical characteristics of Japanese patients with CASIAMI and non-obstructive coronary arteries. We experienced 62 patients with MINOCA (10 thrombosis, 7 unknown causes, and 45 CASIAMI) among 991 patients with suspected AMI. Pharmacological spasm provocation testing was performed in 37 patients. CASIAMI without obstructive coronary arteries was found in 4.5% of patients with suspected AMI and was observed in 73% of patients with MINOCA. Patients with CASIAMI were frequently males and had relatively small AMIs. Spontaneous spasm was recognized in 8 patients. We could reproduce provoked spasm in 37 patients with MINOCA, including 23 patients with multiple spasm. No patients died during the follow-up period. The clinical outcomes in patients with CASIAMI under optimal coronary vasodilators were satisfactory.
冠状动脉痉挛诱发的急性心肌梗死（CASIAMI）是冠状动脉非阻塞性心肌梗死（MINOCA）的病因之一。我们回顾性分析了日本CASIAMI和冠状动脉非阻塞性患者的发病率及临床特征。在991例疑似急性心肌梗死（AMI）患者中，我们遇到了62例MINOCA患者（10例血栓形成，7例病因不明，45例CASIAMI）。对37例患者进行了药物性痉挛激发试验。在疑似AMI患者中，4.5%发现有无阻塞性冠状动脉的CASIAMI，在MINOCA患者中，73%观察到该情况。CASIAMI患者多为男性，急性心肌梗死相对较小。8例患者出现自发性痉挛。我们能够在37例MINOCA患者中重现激发性痉挛，其中23例为多发性痉挛。随访期间无患者死亡。在最佳冠状动脉血管扩张剂治疗下，CASIAMI患者的临床结局令人满意。
Zotero 插件