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The Portuguese MINOCA patients: insights from a multicentre national registry analysis
Session:
Sessão de Posters 32 - MINOCA
Speaker:
Carolina Miguel Gonçalves
Congress:
CPC 2024
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.7 Acute Coronary Syndromes - Other
Session Type:
Cartazes
FP Number:
---
Authors:
Carolina Miguel Gonçalves; Margarida Cabral; Mariana Carvalho; Adriana Vazão; André Martins; Fátima Saraiva; João Morais; Em Nome Dos Investigadores do Registo de Síndromes Coronárias Agudas da Sociedade Portuguesa de Cardiologia
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Background</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Myocardial infarction with nonobstructive coronary arteries (MINOCA) is defined by clinical symptoms compatible with acute myocardial infarction (AMI) but without significant stenosis in a major epicardial artery. Several gaps in evidence for MINOCA exist, particularly in diagnosis, management, and outcomes.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Purpose</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">To describe clinical characteristics and prognosis of Portuguese MINOCA patients.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Material and methods</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">Retrospective multicentre analysis of patients clinically suspected of MINOCA included in the Portuguese Registry on Acute Coronary Syndromes between 2010 and 2022. Baseline characteristics/findings, treatment and prognosis were analised. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results </strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">The authors studied 3668 patients (9% of the total) with a mean age of 65 ± 13 years, of whom 65% were male. The diagnosis of MINOCA appeared to be increasing in Portugal, especially in men, despite a decrease in 2020. A high frequency of cardiovascular risk factors was observed, including high blood pressure (67%), dyslipidemia (55%), diabetes (27%), and smoking (25%). The most common symptom was chest pain (93%), and the admission diagnoses were non-ST-segment myocardial infarction (51%) and ST-segment myocardial infarction (48%) in Killip class 1 (88%). A composite of in-hospital complications occurred in 10%, and one-year mortality occurred in 2.9%. After multivariate analysis, age over 75 years (OR 2.889, 95% CI 1.131-7.378, p=0.027), Killip class above 1 (OR 3.920, 95% CI 1.59-9.66, p=0.003), and diuretics (OR 11.119, 95% CI 4.280-28.884, p<0.001) remained as independent predictors of in-hospital major adverse cardiac events.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Conclusions</strong></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000">This study highlights an increasing trend in MINOCA diagnoses in Portugal, possibly with an underrepresentation of women. Although some studies indicate better outcomes compared to AMI due to coronary artery disease, our research identified in-hospital complications and 1-year outcomes. Further investigation is crucial to advance our understanding and refine treatment options for this condition.</span></span></span></p>
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