Argentine MINOCA Registry. Description of the Population

pp. 108-116

Abstract

Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a well-known condition that has been recently redefined after excluding non-ischemic myocardial injury. ReSCAR was a prospective, multicenter registry of patients hospitalized for acute coronary syndrome (ACS) from January to August 2022.

Objective: One of the main objectives of the registry was to define the prevalence of patients with MINOCA, their baseline clinical and paraclinical characteristics, and in-hospital outcome. This publication focuses on the results of the respective analysis.

Methods: We conducted a nationwide, multicenter, prospective study of patients with ACS. The diagnosis of MINOCA was made following the fourth definition of myocardial infarction. The baseline characteristics of the patients were analyzed, as well as their outcome and significant differences with patients with obstructive coronary artery disease. The participating centers should have the availability to measure high-sensitivity cardiac troponin and perform coronary angiography.

Results: A total of 984 patients from 15 centers were included. Eighty-five patients (8.6%) had a final diagnosis of MINOCA at discharge. Median age was 65 years (53-63), 48 (51.8%) were women, 55 (64.7%) had hypertension, 44 (51.8%) had dyslipidemia, 9 (10.6%) were diabetics and 23 (27.1%) were smokers. Median high-sensitivity cardiac troponins on admission (expressed as multiples of the 99th percentile) were 2.42 times higher (0.85-10.21) and the ECG had no ischemic changes in 71.8% of the patients. Coronary angiography was normal in 72.9% of the patients and the rest of the cases had coronary artery stenoses < 50%. Sixteen patients underwent cardiac magnetic resonance imaging. The median GRACE score was 115 (98-139), which corresponds to intermediate risk. The event rate for the composite outcome of stroke/myocardial infarction or death was1.2%, and there were no bleeding events BARC ≥ type 2. The discharge prescription rate was 72.9% for aspirin, 27.1% for clopidogrel, 88.2% for statins, 67.1% for betablockers, and 22.4% for calcium channel blockers.
In this registry, patients with MINOCA represent a significant proportion of those with ACS.

Conclusion: The rate of in-hospital complications, including mortality, was low. There seems to be a strong opportunity for further investigations to confirm the diagnosis, pathophysiological mechanisms, and treatment of MINOCA.

How to cite this article:

Rivero M, Gingins M, Roel V, Procopio FG, Villarreal RA, Arbucci R, y cols. Argentine MINOCA Registry. Description of the Population. Rev Argent Cardiol. 2024;92:108-16. http://dx.doi.org/10.7775/rac.v92.i2.20476