Abstract 19581: In-hospital Management and Outcomes in Patients with Myocardial Infarction and Non-obstructive Coronaries
OBJECTIVE: To assess contemporary therapy and outcomes in patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA) compared to those who have myocardial infarction with obstructive CAD (MICAD).
METHOD: The Coronary Angiogram Database of South Australia (CADOSA) Registry utilizes the CathPCI® Registry data elements and definitions, with data obtained by trained data collectors who capture all South Australian public hospital coronary angiograms.
Results: In 2012, coronary angiography was performed in 1,176 myocardial infarct patients of whom 197 (11%) had MINOCA. Compared with MICAD patients, the MINOCA patients were significantly younger (64±13 vs. 59±15 years, p <0.01), more likely to be female (26% vs. 50%, p<0.01) and have depression (50% vs. 68%, p<0.01) but less likely to have diabetes (31% vs. 21%, p=0.2), dyslipidemia (60% vs. 49%, p<0.01) or smoke (37% vs. 27% p<0.01). Also in comparison to the MICAD patients, the MINOCA patients were less likely to receive secondary prevention therapies at discharge including aspirin (90% vs. 57%, p<0.01) beta-blockers (62% vs. 39%, p<0.01), statin (85% vs. 54%, p<0.01), ACE-inhibitor/angiotensin receptor blocker (76% versus 58%, p <0.01), and cardiac rehabilitation referral (55% vs. 23%, p<0.01). Alarmingly, compared to MICAD patients, in-hospital mortality tended to be higher in those with MINOCA (2.9% vs 3.6%, p=0.36).
CONCLUSION: MINOCA is not an infrequent finding and affected patients often have significant coronary risk factors, yet often do not receive secondary preventative therapies. Whether this contributes to their surprisingly high in-hospital mortality, requires further investigation.
Author Disclosures: R. Tavella: None. S. Pasupathy: None. M. Arstall: None. D. Chew: Research Grant; Modest; Astra Zeneca Australia. Speakers Bureau; Modest; Astra Zeneca Australia. Research Grant; Significant; Astra Zeneca Australia. M. Worthley: None. C. Zeitz: None. J. Beltrame: Speakers Bureau; Modest; Servier Laboratories.
- © 2014 by American Heart Association, Inc.