One-Year Prognosis Difference of Myocardial Infarction With or Without Coronary Obstruction in Developing Countries: Insights From the Moroccan Experience

Overview

Journal Clin Med Insights Cardiol

Publisher Sage Publications

Specialty Cardiology & Vascular Diseases

Date 2024 Oct 1

PMID 39351278

Authors

Amine Bouchlarhem

Ihssane Merimi

Zakaria Bazid

Nabila Ismaili

Noha El Ouafi

Affiliations

Soon will be listed here.

Abstract

Introduction: The debate remains open as to the difference in prevalence of mortality and occurrence of acute events in patients with Myocardial infarction with non-obstructive coronary arteries (MINOCA) and others with Myocardial infarction with coronary arteries disease (MI-CAD).

Methods: We conducted a 2-year retrospective study for patients admitted for Acute coronary syndrome (ACS) to analyze the clinical and prognostic characteristics of patients with MINOCA versus MI-CAD. We defined 1-year all-cause mortality as the primary outcome, and the secondary outcome as a composite of 1-year readmission for myocardial infarction or acute heart failure (AHF).

Results: Our study included 1077 patients, 95.3% with MI-CAD and 4.7% with MINOCA. At admission, 71.1% patient were diagnosed STEMI and 28.9% with NSTEMI. The difference between the 2 groups was found on age ( < .001), hypertension, diabetes with consecutive -values of .007 and .001, as well as Ejection fraction ( < .001). For the outcomes studied, the difference was significant between the 2 groups for all events, and MINOCA patients had a better prognosis than MI-CAD patients, with adjusted hazard ratios (HR) for 1-year mortality (HR = 0.601 = .004), for readmission for ACS (HR = 0.662; = .002) and for readmission for AHF (HR = 0.539; = .019).

Conclusion: Despite the ambiguity in the genesis of MINOCA, the short- and long-term prognosis of these patients remains generally favorable.

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