Prevalence and risk factors of patients with myocardial infarction with non-obstructive coronary artery in Udon Thani Hospital

Abstract

           Ischemic heart disease is a leading cause of death worldwide. The development of healthcare  system, highly sensitive investigation and early revascularization strategies, has revealed that a  substantial group of patients with the presence of acute myocardial infarction and absence of  obstructive coronary artery disease (≥50% stenosis), referred as myocardial infarction with non obstructive coronary artery (MINOCA). Patients with MINOCA are often younger, more likely to be  women, less likely to have dyslipidemia, and have major adverse cardiac endpoints (MACE) more than  normal population.

            This is a retrospective descriptive analytic study for prevalence and risk factors of  MINOCA in Udon Thani hospital between 2016 to 2021 and 2023 to 2024 There were 46 patients with MINOCA among  all 603 myocardial infarction patients. Prevalence of MINOCA is 7.6 %. The factors which significantly affected with MINOCA were  Sepsis (OR = 21.14 ; 95%CI: 2.05 - 218.10, p = 0.01 and higher left ventricular ejection fraction (LVEF) (OR = 1.10 ; 95%CI: 1.03 - 1.16 , p=0.003). There was no significant difference between MINOCA and  obstructive coronary disease patients in MACE outcomes - cardiac arrest in 48 hours, all-cause  mortality in a month, all-cause mortality in a year and cerebrovascular event in a year after event.