Frequency and Outcome of Myocardial Infarction with Non-Obstructive Coronary Arteries (Minoca) at Tertiary Care Hospital
DOI:
https://doi.org/10.70749/ijbr.v3i5.2524Keywords:
Myocardial Infarction, Non-Obstructive Coronary Arteries, Cardiogenic Shock, Ventricular Arrhythmias, Mechanical Complications, Mortality.Abstract
Background: It is defined as the presence of positive cardiac biomarker with clinical evidence of infarction, absence of (≥50%) stenosis in any epicardial coronary arteries on coronary angiography, and lack of any alternative diagnosis for the index presentation. MINOCA tends to affect younger females more frequently. Objective: To determine the frequency of myocardial infarction with non-obstructive coronary arteries. To determine the frequency of outcome (cardiogenic shock, ventricular arrhythmias, mechanical complications like papillary muscle rupture in patients having myocardial infarction with non-obstructive coronary arteries (MINOCA). Material and Methods: The cross-sectional study enrolled 164 patients ranging from 18–75 years of age, undergoing coronary angiography for myocardial ischemia. MINOCA was identified by absence of ≥50% stenosis on angiography without an alternative diagnosis. Statistical analysis was performed using SPSS Version 25 with Shapiro-Wilk test for normality and Chi-square or Fisher’s exact test for categorical variables, considering a p-value of ≤0.05 as significant. Results: In our study, mean age was 60 ± 9.83 years, 59.8% male, 70.7% urban residents. MINOCA was diagnosed in 39% of cases, with Mild luminal irregularities in 7.3% and moderate coronary lesions in 31.7%. Adverse outcomes were notable, with cardiogenic shock observed in 11%, ventricular arrhythmias in 4.3%, mechanical complications in 3.7%, and mortality in 2.4% of patients. Multivariate analysis revealed that age ≤50 years, urban residency, and poor glycemic control independently predicted adverse outcomes. Conclusion: Our study demonstrates that MINOCA is prevalent in our cohort (39%). Cardiogenic shock occurred in 11% patients, ventricular arrhythmias in 4.3%, mechanical complications (3.7%), and mortality was 2.4%
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