Clinical Characteristics And Prognosis In Patients Suffering Acute Myocardial Infarction With Non-obstructed Coronary Arteries

Objective:To explore the clinical features,prognosis,and factors affecting the prognosis of myocardial infarction with non-obstructive coronary arteries(MINOCA).Methods:A retrospective analysis of the clinical data of 87 patients diagnosed as MINOCA in the Department of Cardiology of the First Affiliated Hospital of Hunan Normal University from January 1,2016 to December31,2018.According to the admission time of MINOCA group ± 5 days,87 patients with myocardial infarction with obstructive coronary arteries(MICAD)were randomly selected 1:1(MICAD group).Major adverse cardiovascular events(MACE)were used as the final events of this study.Baseline data,medications,and MACE 1 year after discharge were compared between the two groups.The Cox proportional hazards regression model was used to analyze the independent risk and protective factors affecting the adverse prognostic outcome of MINOCA patients.Reslults:1.The proportion of MINOCA in the diagnosis of AMI is 4.33%.Compared with the MICAD group,the age of onset in the MINOCA group is younger(60.66±12.40 vs 56.15±13.64)years,the proportion of males is lower(81.6% vs 54.0%),the proportion of combined diabetes is less(32.2% vs 12.6%),and the proportion of smoking is more Low (65.5% vs 39.1%),the differences were statistically significant (P<0.05).2.During follow-up,compared with the MICAD group,the MINOCA group took aspirin(92.7% vs 74.1%),ADP receptor antagonists(78.0% vs 60.5%),statins(81.7% vs 59.3%),renin-vascular The ratio of angiotensin inhibitors(67.1% vs 50.6%)and β-blockers (72.0% vs 53.1%)is lower,and the differences are statistically significant(P<0.05).3.The incidence of MACE in the MINOCA group and MICAD group at 1 year after discharge was 19.8% and 24.4%,respectively,with no statistically significant difference(P>0.05).4.Cox regression analysis results show that smoking(HR=2.46,95%CI: 1.05-5.74,P<0.05)and age(HR=1.08,95%CI: 1.01-1.18,P<0.05)are the occurrence of MACE in MINOCA patients Independent risk factors,and discharge of statins(HR=0.69,95%CI: 0.32-0.99,P<0.05)is an independent protective factor for the occurrence of MACE.Conclusions:1.Compared with patients in MICAD group,MINOCA is younger onset,and the use rate of secondary prevention drugs for coronary heartdisease in MINOCA patients is lower.2.The 1-year incidence of MACE in the MINOCA group is similar to that in the MICAD group.3.Smoking and age are independent risk factors for the poor prognosis of MINOCA patients.Taking statins on discharge from the hospital is an independent protective factor for their poor prognosis.