PB0055 - Myocardial infarction with non-obstructive arteries (MINOCA): baseline characteristics and the role of thrombotic mechanism in a spanish university center

Background: Myocardial infarction with non-obstructive arteries (MINOCA) and its importance in clinical practice has been studied largely over the years. The etiology, the clinical profile of this population and the determining factors continue to be of large interest.

Aims: To describe MINOCA characteristics and to establish the role of the thrombotic mechanism.

Methods: This is a descriptive, cross-sectional, single-center study. Two years of data from the SERGAS electronic system from a Spanish university hospital were analyzed. The mean range was reported for continuous variables and frequencies for categorical variables. Statistical analysis was made using SPSS, version 22.

Results: From 1583 patients admitted to the Coronary Care Unit, 147 presented < 50% lesions. For an other cause of troponin elevation were excluded 71 patients. The prevalence of MINOCA was 7.7%(n =76) in the studied population.The majority were women(52.6%) and the average age was 66years (±14,265). The length of hospital stay was 5.2 day (±3,596). The majority of patients had comorbidities (Table1). Active smokers were observed in 21.1%. Most of patients were known with arrhythmias 25%(n=19), but only one of those who wasn’t anticoagulated provoked an myocardial infarction with thromboembolic mechanism. Moreover, psycho-emotional disorders were established in 30,3%(n=23) of MINOCA patients. Other comorbidities included known cancer (n=13/17,6%) and stroke (n=3/3,9%)(see Table 1). In 14,5%(n=11) patients were on antiplatelet therapy and 10,5%(n=8) were on anticoagulation drugs. The intracoronary imaging as intracoronary ultrasound was used in 5,3%(n=4) and an optical coherence intracoronary tomography in 11,8%(n=9). Angiographic characteristics included: 35.5% atherosclerosis, 26.3% smooth coronary arteries and 13.2% spontaneous coronary artery dissection. Other causes of MINOCA: 9.2% coronary thromboembolism, of which 4 patients (57%) were resolved only with thromboaspiration; 6.6% coronary spasm and 5.3% in-situ thrombosis. All patients were tested for thrombophilia, with all negative test.

Conclusion(s): No direct relationship was found between arrhythmias and the thromboembolic mechanism, nor with thrombophilias.