Metabolic syndrome and the risk of adverse cardiovascular events in patients with myocardial infarction with non-obstructive coronary arteries

2022 ◽  
Author(s):  
Fuad A. Abdu ◽  
Abdul-Quddus Mohammed ◽  
Lu Liu ◽  
Guoqing Yin ◽  
Siling Xu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Coronary Arteries ◽  
Cardiovascular Events

Impact of metabolic syndrome on future cardiovascular events in patients with first acute myocardial infarction

2009 ◽  
Vol 20 (6) ◽  
pp. 370-375 ◽  
Author(s):  
Hatice Selcuk ◽  
Ahmet Temizhan ◽  
Mehmet Timur Selcuk ◽  
Taner Sen ◽  
Orhan Maden ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Acute Myocardial Infarction ◽  
Cardiovascular Events

Metabolic Syndrome and Risk of Cardiovascular Events After Myocardial Infarction

2005 ◽  
Vol 14 (10) ◽  
pp. 4
Author(s):  
G. Levantesi ◽  
A. Macchia ◽  
R. Marfisi
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Cardiovascular Events

scholarly journals Metabolic Syndrome and Risk of Cardiovascular Events After Myocardial Infarction

2005 ◽  
Vol 46 (2) ◽  
pp. 277-283 ◽  
Author(s):  
Giacomo Levantesi ◽  
Alejandro Macchia ◽  
RosaMaria Marfisi ◽  
Maria G. Franzosi ◽  
Aldo P. Maggioni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Cardiovascular Events

scholarly journals Importance of confirming the underlying diagnosis in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA): a single-centre retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
T. F. S. Pustjens ◽  
A. Meerman ◽  
N. P. A. Vranken ◽  
A. W. Ruiters ◽  
B. Gho ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
Cardiovascular Events ◽  
Troponin T ◽  
Multivariable Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cardiac Events ◽  
Ventricular Ejection Fraction ◽  
Conclusive Diagnosis

Abstract Background Many patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) are discharged without a known aetiology for their clinical presentation. This study sought to assess the effect of this ‘indeterminate MINOCA’ diagnosis on the prevalence of recurrent cardiovascular events and presentations to the Cardiac Emergency Department (CED). Methods We retrospectively analysed all patients meeting the diagnostic MINOCA criteria presenting at a large secondary hospital between January 2017 and April 2019. Participants Patients were divided into the (1) ‘indeterminate MINOCA’, or (2) ‘MINOCA with diagnosis’ group. The primary outcome was the occurrence of major adverse cardiac events (MACE) defined as the composite of all-cause mortality, non-fatal myocardial infarction, stroke and any revascularisation procedure. Secondary outcomes were all recurrent visits at the CED, and MACE including unplanned cardiac hospitalisation. Results In 62/198 (31.3%) MINOCA patients, a conclusive diagnosis was found (myocardial infarction, (peri)myocarditis, cardiomyopathy, or miscellaneous). MINOCA patients with a confirmed diagnosis were younger compared to those with an indeterminate diagnosis (56.7 vs. 62.3 years, p = 0.007), had higher maximum troponin-T [238 ng/L vs. 69 ng/L, p < 0.001] and creatine kinase (CK) levels [212U/L vs. 152U/L, p = 0.007], and presented more frequently with electrocardiographic signs of ischaemia (71.0% vs. 47.1%, p = 0.002). Indeterminate MINOCA patients more often showed recurrent CED presentations (36.8% vs. 22.6%, p = 0.048), however the occurrence of cardiovascular events was equal (8.8 vs. 8.1%, p = 0.86). Multivariable analysis showed that elevated levels of troponin-T and CK, ST-segment deviation on electrocardiography, reduced left ventricular ejection fraction, regional wall motion abnormalities, and performance of additional examination methods were independent predictors for finding the underlying MINOCA cause. Conclusions Only in one-third of MINOCA patients a conclusive diagnosis for the acute presentation was identified. Recurrent CED visits were more often observed in the indeterminate MINOCA group, while the occurrence of cardiovascular events was similar across groups. Trial registration Retrospectively registered

scholarly journals Prognostic impact of recommended treatment in patients with myocardial infarction with nonobstructive coronary arteries

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Galan Gil ◽  
J Lopez Pais ◽  
B Izquierdo Coronel ◽  
R Olsen Rodriguez ◽  
R Abad Romero ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Practice ◽  
Antiplatelet Therapy ◽  
Coronary Arteries ◽  
Cardiovascular Events ◽  
Hospital Death ◽  
Angiotensin Ii Receptor Blocker ◽  
Prognostic Impact ◽  
Recommended Treatment

Abstract Introduction Myocardial infarction with non-obstructive coronary arteries (MINOCA), and specially its treatment, is still a challenge in the clinical practice. The Position Paper of the European Society of Cardiology (PP-ESC) of 2016 recommend to treat this patients (pts) like those with obstructive arteries: double antiplatelet therapy (DAPT), betablockers, angiotensin converting enzyme inhibitors (ACEi) or angiotensin II receptor blocker (ARB) and statins. The aim of this study is to analyze the use of the recommended treatment in the clinical practice, and the impact in the prevention of cardiovascular events. Methods Analytical and observational study developed in a Universitary Hospital which covers over 220.000 individuals. From January-2016 to December-2019, we registered all the ptsthat were admitted for MINOCA. We analyzed the treatment at discharge and its relationship with mayor adverse cardiovascular events (MACE) at the year of follow up. Results During the period studied, 115 pts were diagnosed of MINOCA, with only one case of in-hospital death. At discharge, DAPT AAS were prescribed in 61%, and a second antiplatelet therapy (clopidogrel, ticagrelor or prasugrel) in 36% of pts. Only 63% of MINOCA pts were on betablockers at discharge, while 61% were on ACEi or ARB and 39% with both of them. Regarding other cardiovascular treatment nitrates were prescribed in 10% of MINOCA pts, calcium channel blocker (CCB) in 15% and nondihydropyridine-CCB in 5%. Statins were used in 61% of pts. We completed the follow up of 97 of the 114 MINOCA pts discharged (85%). After one year of follow up, MACE occurred in 10 pts (10%). This events were less frequent among MINOCA pts treated with betablockers (3,3% vs 22,2%, p 0,005) and with ACEi/ARB (5,1% vs 18,4%, p 0,045). There were a significant difference in MACE between MINOCA pts who takes both betablockers and ACEi/ARB and those without these treatments (2.9% vs 40%, p 0,001). On the other hand, the use of nitrates and CCB were associated with a significant increase of MACE (5,7% vs 50%, p&lt;0,001; 7,3% vs 26,7%, p&lt;0,045). The use of statins or DAPT was not related with MACE in MINOCA pts. Conclusion This study showed a reduction in MACE with the use of betablockers and ACEi/ARB in MINOCA pts, and even an added effect with the joint use of them. Otherwise, the use of DAPT or statins did not reduce MACE. Surprisingly, nitrates and CCB appeared to increase the events, maybe showing that these drugs have to be used carefully in MINOCA pts or that the etiology of MINOCA in this concrete pts is the cause of the worse prognostic. In conclusion, more studies are needed to improve the knowledge of MINOCA and its correct treatment. Funding Acknowledgement Type of funding source: None

scholarly journals Myocardial Infarction with Nonobstructive Coronary Arteries: A Diagnostic Challenge

TH Open ◽  
2021 ◽  
Vol 05 (02) ◽  
pp. e195-e199
Author(s):  
Kofi Tekyi Asamoah
Keyword(s):  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Coronary Arteries ◽  
Cardiovascular Events ◽  
White Women ◽  
Clinical History ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Angiogram ◽  
Diagnostic Challenge ◽  
Pathophysiologic Mechanisms

AbstractMyocardial infarction with nonobstructive coronary arteries (MINOCA) is a significant cause of cardiovascular morbidity, especially among non-white women younger than 55 years. It is a working diagnosis that warrants further investigation due to its varied underlying pathophysiologic mechanisms. Investigations may be hampered by unavailability of testing modalities, cost, and the expertise to carry out the tests, as they are highly specialized. Clinical history is therefore important, especially in developing countries, to predict potential causes and institute empirical treatment without the luxury of tests. Some physicians are also unaware of this phenomenon and may dismiss symptoms as functional when a coronary angiogram shows nonobstructed coronary arteries, potentially resulting in patients suffering symptoms for longer and incurring extra cost. Most importantly, it leaves them at risk of major adverse cardiovascular events. This article presents a patient with atrial fibrillation who was diagnosed with MINOCA and highlights the diagnostic challenges in evaluating MINOCA.

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