Clinical features in patients with non-ST-segment elevation myocardial infarction with nonobstructive coronary arteries
DOI:
https://doi.org/10.52692/1857-0011.2024.1-78.07Keywords:
инфаркт миокарда без подъема сегмента ST, инфаркт миокарда без обструктивного поражения коронарных артерийAbstract
Aim: Estimation of the rate of non-ST-segment elevation myocardial infarction with non-obstructive coronary arteries (NSTE-MINOCA) and comparative analysis of clinical and management data with non-ST-segment elevation myocardial infarction with obstructive coronary arteries (NSTEMI-CAD). Material and methods: 494 patients diagnosed with NSTEMI were included in the study. The patients were divided into 2 research groups according to the presence of obstruction in the coronary arteries: group I - 35 patients with MINOCA and group II - 459 MI-CAD. Results: The MINOCA rate in the NSTEMI group was 7.08%. The risk factors: smoking, diabetes mellitus and hypertension was higher in the MI-CAD vs. MINOCA group. The concentrations of myocardial necrosis markers was higher in MI-CAD vs MINOCA: troponin - 8.58±0.89 vs 2.8±1.3, CK-MB 20.7±1.78 vs 13.97±2.6 ng/L, p<0.05 and high-sensitivity troponin - 767.4 vs 8248 ng/L, p<0.001. Patients with MINOCA had higher levels of C-reactive protein (CRP (36.62±16.27) vs MI-CAD (22.16±2.39), p<0.05. Regarding the treatment, the study highlighted that patients with MINOCA used less the double antiplatelet therapy (28.6 vs 89.2%), statins (45.7 vs 83.1%) and ACEI/BRA (90.4 vs 57.1%) than MI-CAD patients (p<0.001). Conclusions: The NSTE- MINOCA rate was 7,08%. MINOCA patients have a lower rate of risk factors. In MINOCA there are lower concentrations of myocardial necrosis markers and increased values of inflammatory markers compared to MI-CAD.
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