Long-term outcomes and predictors of patients with ST elevated versus non-ST elevated myocardial infarctions in non-obstructive coronary arteries: a retrospective study in Northern China

PeerJ

article

Lin Chen¹  Yinghong Fan¹  Zhen Fang³  Ning Liu³ 

[1] Institute of Gastroenterology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province;Pancreatic Center, Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province;Department of Cardiology, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu Province

关键词: MINOCA;    ST-segment elevation;    Non-ST-segment elevation;    Outcomes;    Predictors;   

DOI  :  10.7717/peerj.14958

学科分类：社会科学、人文和艺术（综合）

来源: Inra

【 摘 要 】

BackgroundMyocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous disease entity with diverse etiologies and no uniform treatment protocols. Patients with MINOCA can be clinically classified into two groups based on whether they have an ST-segment elevation (STE) or non-ST segment elevation (NSTE), based on electrocardiogram (ECG) results, whose clinical prognosis is unclear. This study aimed to compare the outcomes and predictors of patients with STE and NSTE in the MINOCA population.MethodsWe collected the data for 196 patients with MINOCA (115 with STE and 81 with NSTE) in China. Clinical characteristics, prognoses, and predictors of major adverse cardiovascular events (MACE) were analyzed during the follow-up of all patients.ResultsThe proportion of patients with STE was greater than that with NSTE in the MINOCA population. Patients with NSTE were older and had a higher incidence of hypertension. No differences were observed in the outcomes between the STE and NSTE groups during a median follow-up period of 49 (37,46) months. No significant differences were observed in those with MACE (24.35% vs 22.22%, P = 0.73) and those without MACE. The multivariable predictors of MACE in the NSTE groups were Killip grades ≥ 2 (HR 9.035, CI 95% [1.657–49.263], P = 0.011), reduced use of β-blockers during hospitalization (HR 0.238, CI 95% [0.072–0.788], P = 0.019), and higher levels of low-density lipoprotein cholesterol (LDL-C) (HR 2.267, CI 95% [1.008–5.097], P = 0.048); the reduced use of β-blockers during hospitalization was the only independent risk factor of MACE in the STE group.ConclusionsThere were differences between the clinical characteristics of patients with STE and NSTE in the MINOCA population, even though outcomes during follow-up were similar. Independent risk factors for major adverse cardiac events were not identical in the STE and NSTE groups, which could be attributable to the differences in disease pathogenesis.

【 授权许可】

CC BY