演題

Comparison of Long-term Prognosis of Patients with Myocardial Infarction with Obstructive CAD (MICAD) and MI with Non-obstructive CAD (MINOCA)

[演者] 小鷹 悠二:1
[共同演者] 浪打 成人:1, 牛込 亮一:1, 瀧井 暢:1, 杉江 正:1, 加藤 敦:1
1:仙台市医療センター仙台オープン病院 循環器内科

Background: Past studies demonstrated that in approximately 10% of patients with AMI, angiography does not reveal obstructive coronary artery disease (CAD). These patients are labeled as having "myocardial infarction with non-obstructive CAD (MINOCA)", which is being increasingly recognized with the more widespread use of coronary angiography in AMI. However, especially in Japan, clinical characteristics and prognosis remains to be elucidated. Methods and Results: We enrolled 955 consecutive patients who diagnosed as AMI. We divided them into two groups, patients with myocardial infarction with obstructive coronary artery disease (MICAD, n=912) and with MINOCA (n=43). In MINOCA group, patients were significantly younger (61±17 vs 67±13, P<0.01), more frequently in female (42% vs 34%, P<0.01) and lower prevalence of DM (9% vs 34%, P<0.01). Patients with MICAD were more frequently with pre-angina (44% vs 26%, P<0.05), STEMI (72% vs 51%, P<0.01) and higher peak CK levels (1414 vs 427 IU/L, P<0.01). In hospital mortality were tended to be higher in MICAD patients (7% vs 0%, P=0.082). However, in the long-term prognosis of these patients, all-cause death (P=0.50), cardiac death (P=0.88), re-hospitalization by heart failure (P=0.90), ACS (P=0.25) and composite end point (P=0.94) were comparable between MICAD and MINOCA. Conclusions: Present study indicated there were different patient characteristics between MICAD and MINOCA. Otherwise, MINOCA did not have a good prognosis as compared with MICAD.

[Keywords] acute coronary syndrome / myocardial infarction
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