Prognosis and Predictors of Mortality in Patients Suffering Myocardial Infarction With Non-Obstructive Coronary Arteries
Prognosis and Predictors of Mortality in Patients Suffering Myocardial Infarction With Non-Obstructive Coronary Arteries
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DOI：
10.1161/jaha.119.011990
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发表时间：
2019-07-16
影响因子：
5.4
通讯作者：
Hwang, Jin-Yong
中科院分区：
文献类型：
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作者：
Choo, Eun Ho;Chang, Kiyuk;Hwang, Jin-Yong
非阻塞性冠状动脉心肌梗死（MINOCA）是一种异质性疾病。其预后和死亡率的预测因素尚不清楚。本研究旨在比较MINOCA和心肌梗死与阻塞性冠状动脉疾病之间的预后，并确定MINOCA使用全国范围内的，多中心的，前瞻性registration.Methods和Results-Among 13 104例连续入选患者的全因死亡相关因素，既往无显著冠状动脉疾病史的患者进行冠状动脉造影。主要结局为2年全因死亡。次要结局为心源性死亡、非心源性死亡、再梗死和重复血运重建。MINOCA患者（n=396）和心肌梗死伴阻塞性冠状动脉疾病患者（n 10 871）的全因死亡发生率相似（9.1% vs 8.8%;风险比[HR]，1.04; 95% CI，0.74-1.45; P 0.83）。两组之间的心源性死亡、非心源性死亡和再梗死风险无显著差异（HR，0.82; 95% CI，0.53-1.28; P=0.38; HR，1.55; 95% CI，0.93-2.56; P= 0.09; HR，1.23; 95% CI，0.65-2.31; P=0.38）。MINOCA患者再次血运重建的发生率较低（1.3% vs 7.2%; HR，0.17; 95%CI，0.07-0.41; P
Background-Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous disease entity. Its prognosis and predictor of mortality remain unclear. This study aimed to compare the prognosis between MINOCA and myocardial infarction with obstructive coronary artery disease and identify factors related to all-cause death in MINOCA using a nation-wide, multicenter, and prospective registry.Methods and Results-Among 13 104 consecutive patients enrolled, patients without previous history of significant coronary artery disease who underwent coronary angiography were selected. The primary outcome was 2-year all-cause death. Secondary outcomes were cardiac death, noncardiac death, reinfarction, and repeat revascularization. Patients with MINOCA (n=396) and myocardial infarction with obstructive coronary artery disease (n 10 871) showed similar incidence of all-cause death (9.1% versus 8.8%; hazard ratio [HR], 1.04; 95% CI, 0.74-1.45; P 0.83). Risks of cardiac death, noncardiac death, and reinfarction were not significantly different between the 2 groups (HR, 0.82; 95% CI, 0.53-1.28; P=0.38; HR, 1.55; 95% CI, 0.93-2.56; P= 0.09; HR, 1.23; 95% CI, 0.65-2.31; P=0.38, respectively). MINOCA patients had lower incidence of repeat revascularization (1.3% versus 7.2%; HR, 0.17; 95% CI, 0.07-0.41; P