非阻塞性冠状动脉心肌梗死危险因素的识别
Identification of risk factors in myocardial infarction with non-obstructive coronary arteries.
作者信息
Dursun Aydın, Guven Hakan, Basel Mehmet Cem, Atasoy Mustafa Selcuk, Yuksel Ahmet
机构信息
Mudanya University, VM Medical Park Hospital, Department of Cardiology - Bursa, Türkiye.
Mudanya University, VM Medical Park Hospital, Department of Cardiovascular Surgery - Bursa, Türkiye.
出版信息
Rev Assoc Med Bras (1992). 2025 Jul 7;71(6):e20242040. doi: 10.1590/1806-9282.20242040. eCollection 2025.
OBJECTIVE
The aim of this study was to identify the risk factors and potential causes of myocardial infarction with non-obstructive coronary arteries in patients presenting with acute coronary syndrome.
METHODS
This retrospective case series study was conducted at the coronary intensive care unit of our hospital between January 2019 and December 2023. Of 3,107 acute coronary syndrome patients, 195 diagnosed with myocardial infarction with non-obstructive coronary arteries were included. Clinical characteristics, risk factors, laboratory test results, and electrocardiographic, echocardiographic, and coronary angiography findings were analyzed. Additionally, vitamin D, homocysteine, folate, and vitamin B12 levels were compared between myocardial infarction with non-obstructive coronary arteries patients and controls with non-occlusive coronary artery disease without acute coronary syndrome.
RESULTS
Among a total of 3,107 acute coronary syndrome patients, 195 (6.28%) were diagnosed with myocardial infarction with non-obstructive coronary arteries. Their mean age was 53.9 years, and 83% of the patients were male. Hypertension (45%), diabetes mellitus (33%), and smoking (70%) were prominent risk factors. Myocardial bridge was the most common cause of myocardial infarction with non-obstructive coronary arteries (11.2%). The left anterior descending artery was the most frequent single vessel responsible for acute coronary syndrome (26%). Vitamin D, B12, and folate levels were statistically significantly lower in myocardial infarction with non-obstructive coronary arteries patients compared to controls (p<0.05).
CONCLUSIONS
Smoking and hypertension were prominent risk factors for myocardial infarction with non-obstructive coronary arteries. Myocardial bridge was the most commonly identified cause, and vitamin D deficiency was significantly associated with myocardial infarction with non-obstructive coronary arteries.
目的
本研究旨在确定急性冠状动脉综合征患者非阻塞性冠状动脉心肌梗死的危险因素和潜在病因。
方法
本回顾性病例系列研究于2019年1月至2023年12月在我院冠心病重症监护病房进行。在3107例急性冠状动脉综合征患者中，纳入195例诊断为非阻塞性冠状动脉心肌梗死的患者。分析临床特征、危险因素、实验室检查结果以及心电图、超声心动图和冠状动脉造影结果。此外，比较了非阻塞性冠状动脉心肌梗死患者与无急性冠状动脉综合征的非闭塞性冠状动脉疾病对照组的维生素D、同型半胱氨酸、叶酸和维生素B12水平。
结果
在总共3107例急性冠状动脉综合征患者中，195例（6.28%）被诊断为非阻塞性冠状动脉心肌梗死。他们的平均年龄为53.9岁，83%的患者为男性。高血压（45%）、糖尿病（33%）和吸烟（70%）是主要危险因素。心肌桥是非阻塞性冠状动脉心肌梗死最常见的病因（11.2%）。左前降支是导致急性冠状动脉综合征最常见的单支血管（26%）。与对照组相比，非阻塞性冠状动脉心肌梗死患者的维生素D、B12和叶酸水平在统计学上显著较低（p<0.05）。
结论
吸烟和高血压是非阻塞性冠状动脉心肌梗死的主要危险因素。心肌桥是最常见的病因，维生素D缺乏与非阻塞性冠状动脉心肌梗死显著相关。
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