冠状动脉非阻塞性心肌梗死的临床特征分析

Abstract
Figure/Table
References (20)
Related Citation (13)

Download: PDF (477 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To analyze the clinical features of myocardial infarction with non-obstructive coronary artery (MINOCA) and myocardial infarction with obstructive coronary artery (MIOCA). Methods A total of 445 patients with acute myocardial infarction admitted to Renmin Hospital of Wuhan University from January 2017 to January 2019 were randomly selected. According to the results of coronary angiography, they were divided into MINOCA group (89 cases) and MIOCA group (356 cases). The general data, the characteristics of the main complaints, and the electrocardiogram were compared between two groups. Results There were significant differences in age, sex, history of coronary heart disease, troponin I, creatine kinase isoenzyme, myoglobin, pro amino terminal brain natriuretic peptide, left ventricular ejection fraction and high-density lipoprotein cholesterol between two groups (P ＜ 0.05). There was no significant difference in BMI, hypertension, diabetes, hyperlipidemia, smoking, family history, triacylglycerol, total cholesterol, LDL cholesterol, free fatty acids, fasting blood glucose and creatinine between two groups (P ＞ 0.05). The incidence of chest pain and radiation pain in MINOCA group was lower than that in MIOCA group, and the effective rate of nitroglycerin in MINOCA group was higher than that in MIOCA group, the differences were statistically significant (P ＜ 0.05). There was no significant difference between two groups in occurrence time of chest distress, chest pain and symptoms < 3 d (P ＞ 0.05). The incidence of normal and T wave changes in MINOCA group was lower than that in MIOCA group, and the incidence of ST segment elevation, pathological Q wave formation and complete left bundle branch block in MINOCA group was higher than that in MIOCA group, the differences were statistically significant (P ＜ 0.05). There was no significant difference between two groups in the incidence of ST segment depression ≥ 0.05 mV, ventricular premature beat, short array ventricular tachycardia, ventricular tachycardia and ventricular fibrillation (P ＞ 0.05). Conclusion Clinically, MINOCA myocardial enzyme index, cardiac function, chest pain symptoms, and electrocardiogram performance are lighter than MIOCA, and there is no significant difference between two groups in terms of high risk factors except age.

Key words： Myocardial infarction with non-obstructive coronary artery Clinical features Chest pain

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LUO Qunhua LI Mingjiang WANG Xin YANG Zheng

Cite this article:

LUO Qunhua LI Mingjiang WANG Xin YANG Zheng. Analysis of clinical features in patients with myocardial infarction with non-obstructive coronary artery[J]. 中国医药导报, 2020, 17(5): 59-62.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I5/59

[1] Bainey KR，Welsh RC，Alemayehu W，et al. 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 [J]. Int J Cardiol，2018，264：12-17.
[2] Agewall S，Beltrame JF，Reynolds HR，et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries [J]. Eur Heart J，2017，38（3）：143-153.
[3] Niccoli G，Scalone G，Crea F. Acute myocardial infarction with no obstructive coronary atherosclerosis：mechanisms and management [J]. Eur Heart J，2015，36（8）：475-481.
[4] Mehta PK，Beltrame JF. Myocardial infarction with non-obstructive coronary arteries：a humbling diagnosis in 2018 [J]. Heart，2019，105（7）：506-507.
[5] Williams M，Barr PR，Lee M，et al. Outcome after myocardial infarction without obstructive coronary artery disease [J]. Heart，2019，105（7）：524-530.
[6] Thygesen K，Alpert JS，Jaffe AS，et al. Fourth universal definition of myocardial infarction （2018） [J]. Circulation，2018，138（20）：e618-e651.
[7] Tamis-Holland JE，Jneid H，Reynolds HR，et al. Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease：a scientific statement from the American Heart Association [J]. Circulation，2019，139（18）：e891-e908.
[8] Montone RA，Niccoli G，Russo M，et al. Clinical，angiographic and echocardiographic correlates of epicardial and microvascular spasm in patients with myocardial ischaemia and non-obstructive coronary arteries [J]. Clin Res Cardiol，2019. [Epub ahead of print]
[9] Pasupathy S，Air T，Dreyer RP，et al. Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries [J]. Circulation，2015，131（10）：861-870.
[10] Safdar B，Spatz ES，Dreyer RP，et al. Presentation，clinical profile，and prognosis of young patients with myocardial infarction with nonobstructive coronary arteries （MINOCA）：results from the VIRGO study [J]. J Am Heart Assoc，2018，7（13）：e009174.
[11] Barr PR，Harrison W，Smyth D，et al. Myocardial infarction without obstructive coronary artery disease is not a benign condition （ANZACS-QI 10） [J]. Heart Lung Circ，2018，27（2）：165-174.
[12] Smilowitz NR，Mahajan AM，Roe MT，et al. Mortality of myocardial infarction by sex，age，and obstructive coronary artery disease status in the ACTION registry-GWTG （acute coronary treatment and intervention outcomes network registry-get with the guidelines） [J]. Circ Cardiovasc Qual Outcomes，2017，10（12）：e3443.
[13] Daniel M，Agewall S，Caidahl K，et al. Effect of myocardial infarction with nonobstructive coronary arteries on physical capacity and quality-of-life [J]. Am J Cardiol，2017，120（3）：341-346.
[14] Dreyer RP，Tavella R，Curtis JP，et al. Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease：outcomes in a medicare population [J]. Eur Heart J，2019. [Epub ahead of print]
[15] Raparelli V，Elharram M，Shimony A，et al. Myocardial infarction with no obstructive coronary artery disease：angiographic and clinical insights in patients with premature presentation [J]. Can J Cardiol，2018，34（4）：468-476.
[16] Montone RA，Niccoli G，Fracassi F，et al. Patients with acute myocardial infarction and non-obstructive coronary arteries：safety and prognostic relevance of invasive coronary provocative tests [J]. Eur Heart J，2018，39（2）：91-98.
[17] Hausvater A，Pasupathy S，Tornvall P，et al. ST-segment elevation and cardiac magnetic resonance imaging findings in myocardial infarction with non-obstructive coronary arteries [J]. Int J Cardiol，2019，287：128-131.
[18] 苏斌杰，郭长峰，李海玲，等.冠状动脉非阻塞性心肌梗死患者的临床特征、治疗现状及院内预后分析[J].国际心血管病杂志，2019，46（1）：47-51.
[19] Abdu FA，Liu L，Mohammed AQ，et al. Myocardial infarction with non-obstructive coronary arteries （MINOCA） in Chinese patients：clinical features，treatment and 1year follow-up [J]. Int J Cardiol，2019，287：27-31.
[20] Nordenskjold AM，Baron T，Eggers KM，et al. Predictors of adverse outcome in patients with myocardial infarction with non-obstructive coronary artery （MINOCA） disease [J]. Int J Cardiol，2018，261：18-23.