Portal de investigación
Long-term outcome of patients with NSTEMI and nonobstructive coronary arteries by different angiographic subtypes.
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Autores de INCLIVA
Grupos y Plataformas de I+D+i
Abstract
INTRODUCTION AND OBJECTIVES: Discordant data have been reported on the prognosis of myocardial infarction with nonobstructive coronary arteries (MINOCA). Moreover, few data are available on the impact of angiographic subtypes. The objectives of this study were to assess the prognostic impact on the long-term follow-up of the diagnosis of MINOCA and its angiographic subtypes. METHODS: We included 591 consecutive patients with non-ST-segment elevation myocardial infarction (NSTEMI) who underwent coronary angiography. MINOCA was classified according to angiographic findings as smooth coronary arteries, mild irregularities (< 30% stenosis), and moderate atherosclerosis (30%-49% stenosis). The primary endpoint was a composite of mortality, nonfatal myocardial infarction, and revascularization (MACE) at a median of 5 years of follow-up. RESULTS: A total of 121 patients (20.5%) showed no obstructive lesions. MINOCA was associated with a lower occurrence of MACE (P=.014; HR, 0.63; 95%CI, 0.44-0.91) and was confirmed as an independent factor in the multivariate analysis (P=.018; HR, 0.63; 95%CI, 0.43-0.92). On analysis of the separate components of the main endpoint, MINOCA was significantly associated with a lower rate of myocardial infarction and revascularization, but not with mortality. Analysis of angiographic subtypes among MINOCA patients showed that smooth coronary arteries were a statistically significant protective factor on both univariate and multivariate analysis, while mild irregularities and 30% to 49% plaques were associated with a higher risk of MACE. CONCLUSIONS: MINOCA is associated with a lower rate of MACE, driven by fewer reinfarctions and revascularizations. Within the angiographic subtypes of MINOCA, smooth arteries were independently associated with a lower number of MACE.
Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 1885-5857, 1579-2242
- Tipo:
- Article
- Páginas:
- 919-926
- PubMed:
- 33349589
REVISTA ESPANOLA DE CARDIOLOGIA Elsevier Doyma
Citas Recibidas en Web of Science: 4
Documentos
Filiaciones
Keywords
- Coronary artery disease; Enfermedad coronaria; Infarto agudo de miocardio sin elevación del segmento ST; Infarto agudo de miocardio sin lesiones coronarias obstructivas (MINOCA); Myocardial infarction with nonobstructive coronary arteries (MINOCA); Non–ST-segment elevation myocardial infarction
Financiación
Proyectos y Estudios Clínicos
INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER
Investigador Principal: JUAN SANCHIS FORES
CB16/11/00420 . INSTITUTO SALUD CARLOS III
Cita
Garcia S,Gonzalez J,Bonanad C,Fernandez A,Valero E,Minana G,Mollar A,Nunez J,Sanchis J. Long-term outcome of patients with NSTEMI and nonobstructive coronary arteries by different angiographic subtypes. Rev. Esp. Cardiol. 2021. 74. (11):p. 919-926. IF:6,975. (1).
Long-term outcome of patients with NSTEMI and nonobstructive coronary arteries by different angiographic subtypes. Garcia S, Gonzalez J, Bonanad C, Fernandez A, Valero E, Minana G, Mollar A et al. REVISTA ESPANOLA DE CARDIOLOGIA. 2021 noviembre 01. 74 (11):919-926. DOI:10.1016/j.rec.2020.10.008. PMID:33349589.
