Special Inspection Branch, The first people's hospital of Jiashan, Jiaxing, China.
Department of Cardiovasclar medicine, The first people's hospital of Jiashan, Jiaxing, China.
Ann Noninvasive Electrocardiol. 2022 Nov;27(6):e13007. doi: 10.1111/anec.13007. Epub 2022 Oct 10.
To investigate and compare the general information, medication, and the occurrence time of major adverse cardiovascular events (MACE) between patients with myocardial infarction with non-obstructive coronary artery myocardial infarction (MINOCA) and those with obstructive coronary artery disease (MICAD).
A total of 325 acute myocardial infarction (AMI) patients were included (MINOCA: n = 31; MICAD: n = 294). The general information and medication of patients were recorded, including age, gender, prevalence of type 2 diabetes, left ventricular ejection fraction (LVEF), proportion of mitral regurgitation, cTn level, triglyceride level, electrocardiogram (ECG) findings, and drugs used (statins, drugs improving ventricular remodeling, antiplatelet drugs). The above indexes were compared, and statistical analysis was performed at different time points of MACE.
MACE occurred significantly more in the MICAD group than in the MINOCA group (38.8% vs. 12.9%; p = .004) after 1 month to 1.5 years of treatment. The earlier the period of MACE occurred in patients with high coronary artery stenosis, it was an independent risk factor for the occurrence of MACE from 1 month to 1 year after surgery (p = .002), while the later the occurrence of MACE in patients with LVEF ≥55% (p = .029). It was not related to gender, cTn, and electrocardiography (ECG) indexes.
A correlation can be established between the risk factors of MINOCA and the occurrence time of MACE. In addition, MICAD is more commonly seen in male patients and patients with a higher cTn level and lower LVEF.
探讨并比较非阻塞性冠状动脉心肌梗死（MINOCA）与阻塞性冠状动脉疾病（MICAD）心肌梗死患者的一般资料、用药及主要不良心血管事件（MACE）发生时间。
共纳入 325 例急性心肌梗死（AMI）患者（MINOCA：n=31；MICAD：n=294）。记录患者的一般资料和用药情况，包括年龄、性别、2 型糖尿病患病率、左心室射血分数（LVEF）、二尖瓣反流比例、cTn 水平、甘油三酯水平、心电图（ECG）表现及用药（他汀类药物、改善心室重构药物、抗血小板药物）。比较以上指标，并在 MACE 不同时间点进行统计学分析。
治疗 1 个月至 1.5 年，MICAD 组 MACE 发生率明显高于 MINOCA 组（38.8%比 12.9%；p=0.004）。冠状动脉狭窄程度越高，MACE 发生时间越早，是术后 1 个月至 1 年内发生 MACE 的独立危险因素（p=0.002），而 LVEF≥55%患者 MACE 发生时间越晚（p=0.029）。与性别、cTn 和心电图（ECG）指标无关。
MINOCA 的危险因素与 MACE 的发生时间之间存在相关性。此外，MICAD 更常见于男性患者和 cTn 水平较高、LVEF 较低的患者。
