Population-level incidence and outcomes of myocardial infarction with non-obstructive coronary arteries (MINOCA): Insights from the Alberta contemporary acute coronary syndrome patients invasive treatment strategies (COAPT) study

2018 ◽  
Vol 264 ◽  
pp. 12-17 ◽  
Author(s):  
Kevin R. Bainey ◽  
Robert C. Welsh ◽  
Wendimagegn Alemayehu ◽  
Cynthia M. Westerhout ◽  
Dean Traboulsi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Arteries ◽  
Treatment Strategies ◽  
Population Level ◽  
Invasive Treatment ◽  
Coronary Syndrome

scholarly journals ANALYSIS OF DATA FROM MINOCA PATIENTS BASED ON COMPARISON OF TOTAL REGISTER OF ACUTE CORONARY SYNDROME IN THE KRASNODAR REGION WITH FOREIGN REGISTERS

2019 ◽  
Vol 33 (4) ◽  
pp. 38-43
Author(s):  
S. V. Kruchinova ◽  
E. D. Kosmacheva ◽  
S. A. Raff ◽  
V. A. Porkhanov
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Comparative Analysis ◽  
Coronary Arteries ◽  
Krasnodar Krai ◽  
Coronary Syndrome ◽  
Krasnodar Region

The review presents a comparative analysis of data from patients with myocardial infarction with non-obstructive coronary arteries. Data were obtained from the total register of acute coronary syndrome in the Krasnodar Krai and were compared with data of foreign registers.

scholarly journals Acute coronary syndrome: treatment strategies (part 1)

2017 ◽  
Vol 8 (2) ◽  
pp. 74-80
Author(s):  
N. B Perepech
Keyword(s):  
Blood Flow ◽  
Acute Coronary Syndrome ◽  
Treatment Strategies ◽  
Antiplatelet Agents ◽  
Clinical Aspects ◽  
Percutaneous Coronary Interventions ◽  
Invasive Treatment ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Flow Through

Two cases of medical care for patients with acute coronary syndrome are discussed, in which conservative and invasive treatment strategies were applied. The clinical aspects of thrombolytic therapy and percutaneous coronary interventions, the use of antiplatelet agents and anticoagulants for the prevention of atherothrombotic events after the restoration of blood flow through the infarct-responsible coronary artery are considered.

scholarly journals Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Nuria Vicente-Ibarra ◽  
Eloisa Feliu ◽  
Vicente Bertomeu-Martínez ◽  
Pedro Cano-Vivar ◽  
Pilar Carrillo-Sáez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Cardiovascular Magnetic Resonance ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Coronary Arteries ◽  
Coronary Artery Lesions ◽  
Cardiac Events ◽  
Coronary Syndrome ◽  
Adverse Cardiac Events

Abstract Background It is estimated that 5% to 10% of patients with myocardial infarction (MI) present with no obstructive coronary artery lesions. Until now, most studies have focused on acute coronary syndrome, including different clinical entities with a similar presentation encompassed under the term MINOCA (MI with non-obstructive coronary arteries). The aim of this study is to assess the prognosis of patients diagnosed with true infarction, confirmed by cardiovascular magnetic resonance (CMR), in the absence of significant coronary lesions. Methods Prospective multicenter registry study, including 120 consecutive patients with a CMR-confirmed MI without obstructive coronary artery lesions. The primary clinical outcome was major adverse cardiovascular events (MACE: death, non-fatal infarction, stroke, or cardiac readmission), assessed over three years. Results Seventy-six patients (63.3%) were admitted with a diagnosis of acute coronary syndrome, and 44 (36.6%) for other causes (mainly heart failure); the definitive diagnosis was established by CMR. Most patients (64.2%) were men, and the mean age was 58.8 ± 13.5 years. Patients presented with small infarcts: 83 (69.1%) showed late gadolinium enhancement (LGE) in one or two myocardial segments, mainly transmural (in 77.5% of patients) and with a preserved left ventricular ejection fraction (median 54.8%, interquartile range 37–62). The most frequent infarct location was inferolateral (n = 38, 31.7%). During follow-up, 43 patients (35.8%) experienced a MACE, including 9 (7.5%) who died. In multivariable analysis, LGE in two versus one myocardial segment doubled the risk of adverse cardiac events (hazard ratio [HR] 2.32, 95% confidence interval [CI] 0.97–5.83, p = 0.058). Involvement of three or more myocardial segments almost tripled the risk (HR 2.71, 95% CI 1.04–7.04, p = 0.040 respectively). Conclusions Patients with true MI but without significant coronary artery lesions predominantly had small infarcts. Myocardial 3-segment LGE involvement is associated with a significantly higher risk of adverse cardiac events.

scholarly journals Levels IL-4, IL-8, TNF-α in middle-aged men with stented coronary arteries after repeated myocardial revascularization

2021 ◽  
Vol 12 (3) ◽  
pp. 43-50
Author(s):  
Vladimir S. Vasilenko ◽  
Elena A. Kurnikova ◽  
Vadim A. Gostimskiy ◽  
Sergey V. Shenderov ◽  
Aleksandr E. Blinov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Heart Disease ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
Coronary Arteries ◽  
Reference Values ◽  
Proinflammatory Cytokines ◽  
Enzyme Linked Immunosorbent Assay ◽  
Coronary Syndrome ◽  
Anti Inflammatory

Background. It has now been established that inflammatory cytokines are involved in all the stages of the development of coronary heart disease. It has been scientifically proved that the severity of coronary heart disease directly correlates with the increase in the level of proinflammatory cytokines, while data on the role of proinflammatory interleukin IL-8 and anti-inflammatory interleukin IL-4 are contradictory. The aim of the study was to evaluate the levels of proinflammatory cytokines (IL-8, TNF-) and anti-inflammatory interleukin (IL-4) in patients with various forms of coronary heart disease who underwent re-stenting of the coronary arteries. Materials and methods. By the method of enzyme-linked immunosorbent assay, the levels of cytokines were determined in 28 patients who had previously undergone myocardial infarction with stenting of an infarct-related artery, re-admitted due to the development of acute coronary syndrome, who underwent repeated stenting of coronary arteries. The same method was performed on 24 patients who also had previously undergone myocardial infarction with stenting of the infarction-associated artery, who were admitted to the clinic for staged stenting of the coronary arteries. Results. In patients with chronic coronary syndrome the levels of IL-4 a do not exceed the reference values, in patients with acute coronary syndrome the levels of IL-4 there was an increase 3,700,24 and 359,8066,94 pg/ml, р 0,001. In patients with chronic coronary syndrome the levels of IL-8 a do not exceed the reference values, in patients with acute coronary syndrome the levels of IL-8 there was an increase 7,341,29 and 69,7518,25 pg/ml, р 0,001. Conclusions. The increase in the level of IL-4 has a compensatory character and, along with a slight increase in TNF-, can be considered as a positive factor stabilizing the course of the disease.

scholarly journals Results of dynamic Follow-Up for Patients with Myocardial Infarction without Obstructive Lesion of Coronary Arteries: Data of the Overall Register for Acute Coronary Syndrome in Krasnodar Region

2019 ◽  
Vol 14 (2) ◽  
pp. 6-12
Author(s):  
S. V. Kruchinova ◽  
E. D. Kosmacheva ◽  
S. A. Raff ◽  
Z. G. Tatarintseva ◽  
V. A. Porhanov
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Coronary Arteries ◽  
Coronary Event ◽  
Long Term Results ◽  
Daily Monitoring ◽  
Coronary Syndrome ◽  
Obstructive Lesion ◽  
Krasnodar Region

Background Myocardial infarction (MI) without obstructive lesion of coronary arteries (MINOCA) has incidence to 14%. Despite its high prevalence, MINOCA is paid not enough attention, therefore some patients can not receive appropriate treatment. Aim Evaluating the long-term results of clinical observation in patients with MINOCA in comparison with patients with obstructive damage and the subsequent revascularization of myocardium. Material On the basis of Scientific Research Institute RCH – 1 the multicenter cohort observation was organized. Patients from the register CROCS (the register of acute coronary syndrome in Krasnodar Region) with the diagnosis MI were divided into two groups: MINOCA including patients without obstructive damage of coronary arteries and MINOCA including patients with obstructive injury and the subsequent stenting a heart attack connected artery. All patients in 12 months would have control assessment during which they had objective survey; electrocardiography; daily monitoring; test of six-minute walking, echocardiography. Results In the MINOCA group in 12 months after the acute coronary event in 21.5% cases there were tension stenocardia, in 16.2% – a painless form of myocardial ischemia was revealed, in a group of patients with MINOCA stenocardia of tension was revealed at 12.5% and 8.4% – with painless ischemia. The group of patients with MINOCA is characterized by more reliable decrease in both parameters of heart rate variability, and turbulence of heart rate. MINOCA is followed by statistically significant increase in risk of ACS development and death within 12 months. All indicators had reliable difference. Conclusion Patients with MINOCA are a special group, their differential characteristics demand definite diagnostic efforts.

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