P882Predictors of myocardial infarction with non-obstructive coronary arteries (MINOCA)

Abstract Introduction Increasing knowledge about MINOCA can improve its diagnosis and treatment. The aim of this study is to determine the predictors of MINOCA in the initial assessment of myocardial infarction (MI). Methods From 1 January 2016 to 31 December 2018, we carried out an analytical and o...

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Published in:European heart journal 2019-10, Vol.40 (Supplement_1)
Main Authors: Espinosa Pascual, M J, Lopez Pais, J, Izquierdo Coronel, B, Galan Gil, D, Alcon Duran, B, Awamleh Garcia, P, Moreno Vinues, C, Gorriz Magana, J, Fraile Sanz, A, Alonso Martin, J J
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container_title European heart journal
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creator Espinosa Pascual, M J
Lopez Pais, J
Izquierdo Coronel, B
Galan Gil, D
Alcon Duran, B
Awamleh Garcia, P
Moreno Vinues, C
Gorriz Magana, J
Fraile Sanz, A
Alonso Martin, J J
description Abstract Introduction Increasing knowledge about MINOCA can improve its diagnosis and treatment. The aim of this study is to determine the predictors of MINOCA in the initial assessment of myocardial infarction (MI). Methods From 1 January 2016 to 31 December 2018, we carried out an analytical and observational study including all patients admitted to our hospital with MI and underwent coronary angiography. According to the definitions of 2016 ESC Position Paper on MINOCA, we classified the patients in two groups: infarction with obstructive coronary artery disease (MICAD) and MINOCA. We analyzed demographic, clinical, laboratorial and angiographic features. To determine MINOCA independent predictors, a multivariate analysis with logistic regression was carried out in those variables with a statistical signification lower than p
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The aim of this study is to determine the predictors of MINOCA in the initial assessment of myocardial infarction (MI). Methods From 1 January 2016 to 31 December 2018, we carried out an analytical and observational study including all patients admitted to our hospital with MI and underwent coronary angiography. According to the definitions of 2016 ESC Position Paper on MINOCA, we classified the patients in two groups: infarction with obstructive coronary artery disease (MICAD) and MINOCA. We analyzed demographic, clinical, laboratorial and angiographic features. To determine MINOCA independent predictors, a multivariate analysis with logistic regression was carried out in those variables with a statistical signification lower than p<0.01 in the univariate analysis. Results During this 3-year period, 109 patients admitted with MI fully fit the 2016 ESC criteria of MINOCA. The table shows the results regarding our findings. Patients with MINOCA compared to those with MICAD, were younger and with fewer risk factors. Moreover MINOCA was found to be more frequent in women than men. More specifically, MINOCA patients more frequently had a previous history of psychiatric illnesses. They also suffered from higher stress levels either acute or chronic. Inflammatory condition rates were more than two-times higher in the MINOCA group and presented lower levels of troponine. After multivariate analysis, only female patients, inflammatory disorders, stress levels, and lower levels of hemoglobin and troponine, remained independent predictors of MINOCA. Univariate analysis Multivariate analysis MINOCA MICAD P Odds Ratio 95% CI P Female patients 51,4% 21,8% <0.01 2.1 1.12–4.09 0.021 Smokers 41.9% 69.2% <0.01 0.5 0.3–1.02 0.059 Psychiatric disease 22.9% 10.7% <0.01 0.97 0.45–2.08 0.952 Emotional stress 65.9% 34.5% <0.01 3.4 1.81–6.36 <0.01 Autoimmune disorders 34.9% 14.1% <0.01 2.73 1.45–5.1 0.002 Heart rate at admission (lpm) 89±27.1 79±17.7 <0.01 1.92 0.95–3.86 0.068 Troponine I peak (ng/ml) 5.52±8.8 34.05±61.8 <0.01 2.32 1.16–4.65 0.017 Hb (g/dl) 13.5±2.13 14.17±1.83 0.03 2.89 1.48–5.6 0.02 Conclusion MINOCA patients differ in some ways to those patients with MICAD. Being a woman, recognizing emotional stress, having autoimmune disorders and lower levels of troponine and Hb might predict having a MINOCA.]]></description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1093/eurheartj/ehz747.0479</identifier><language>eng</language><publisher>Oxford University Press</publisher><ispartof>European heart journal, 2019-10, Vol.40 (Supplement_1)</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com. 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Espinosa Pascual, M J</creatorcontrib><creatorcontrib>Lopez Pais, J</creatorcontrib><creatorcontrib>Izquierdo Coronel, B</creatorcontrib><creatorcontrib>Galan Gil, D</creatorcontrib><creatorcontrib>Alcon Duran, B</creatorcontrib><creatorcontrib>Awamleh Garcia, P</creatorcontrib><creatorcontrib>Moreno Vinues, C</creatorcontrib><creatorcontrib>Gorriz Magana, J</creatorcontrib><creatorcontrib>Fraile Sanz, A</creatorcontrib><creatorcontrib>Alonso Martin, J J</creatorcontrib><title>P882Predictors of myocardial infarction with non-obstructive coronary arteries (MINOCA)</title><title>European heart journal</title><description><![CDATA[Abstract Introduction Increasing knowledge about MINOCA can improve its diagnosis and treatment. The aim of this study is to determine the predictors of MINOCA in the initial assessment of myocardial infarction (MI). Methods From 1 January 2016 to 31 December 2018, we carried out an analytical and observational study including all patients admitted to our hospital with MI and underwent coronary angiography. According to the definitions of 2016 ESC Position Paper on MINOCA, we classified the patients in two groups: infarction with obstructive coronary artery disease (MICAD) and MINOCA. We analyzed demographic, clinical, laboratorial and angiographic features. To determine MINOCA independent predictors, a multivariate analysis with logistic regression was carried out in those variables with a statistical signification lower than p<0.01 in the univariate analysis. Results During this 3-year period, 109 patients admitted with MI fully fit the 2016 ESC criteria of MINOCA. The table shows the results regarding our findings. Patients with MINOCA compared to those with MICAD, were younger and with fewer risk factors. Moreover MINOCA was found to be more frequent in women than men. More specifically, MINOCA patients more frequently had a previous history of psychiatric illnesses. They also suffered from higher stress levels either acute or chronic. Inflammatory condition rates were more than two-times higher in the MINOCA group and presented lower levels of troponine. After multivariate analysis, only female patients, inflammatory disorders, stress levels, and lower levels of hemoglobin and troponine, remained independent predictors of MINOCA. Univariate analysis Multivariate analysis MINOCA MICAD P Odds Ratio 95% CI P Female patients 51,4% 21,8% <0.01 2.1 1.12–4.09 0.021 Smokers 41.9% 69.2% <0.01 0.5 0.3–1.02 0.059 Psychiatric disease 22.9% 10.7% <0.01 0.97 0.45–2.08 0.952 Emotional stress 65.9% 34.5% <0.01 3.4 1.81–6.36 <0.01 Autoimmune disorders 34.9% 14.1% <0.01 2.73 1.45–5.1 0.002 Heart rate at admission (lpm) 89±27.1 79±17.7 <0.01 1.92 0.95–3.86 0.068 Troponine I peak (ng/ml) 5.52±8.8 34.05±61.8 <0.01 2.32 1.16–4.65 0.017 Hb (g/dl) 13.5±2.13 14.17±1.83 0.03 2.89 1.48–5.6 0.02 Conclusion MINOCA patients differ in some ways to those patients with MICAD. Being a woman, recognizing emotional stress, having autoimmune disorders and lower levels of troponine and Hb might predict having a MINOCA.]]></description><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkEtLAzEUhYMoWKs_QchSF9MmM3ndZSk-Cmq7KOhuyORBU9pJSaZK_fVOqbh2deHAd87lQ-iWkhElUI3dPq2cTt167FbfkskRYRLO0IDysixAMH6OBoQCL4RQH5foKuc1IUQJKgbofaFUuUjOBtPFlHH0eHuIRicb9AaH1utkuhBb_BW6FW5jW8Qmd2nfh58Om5hiq9MB9-suBZfx3evsbT6d3F-jC6832d383iFaPj4sp8_Fy_xpNp28FEZJKMD4qgJWckU1sayRUFnvG6UdtxrAc9-A5sppYojVZcWEbJQUzDReWgpQDRE_1ZoUc07O17sUtv1HNSX1UU79J6c-yamPcnqOnLi43_0T-QHCAm4w</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Espinosa Pascual, M J</creator><creator>Lopez Pais, J</creator><creator>Izquierdo Coronel, B</creator><creator>Galan Gil, D</creator><creator>Alcon Duran, B</creator><creator>Awamleh Garcia, P</creator><creator>Moreno Vinues, C</creator><creator>Gorriz Magana, J</creator><creator>Fraile Sanz, A</creator><creator>Alonso Martin, J J</creator><general>Oxford University Press</general><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20191001</creationdate><title>P882Predictors of myocardial infarction with non-obstructive coronary arteries (MINOCA)</title><author>Espinosa Pascual, M J ; Lopez Pais, J ; Izquierdo Coronel, B ; Galan Gil, D ; Alcon Duran, B ; Awamleh Garcia, P ; Moreno Vinues, C ; Gorriz Magana, J ; Fraile Sanz, A ; Alonso Martin, J J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c879-9cf33942581a0d4b793dffb8ae5da99f5fb9a58ea0c0da23467b8764cbf7d1993</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Espinosa Pascual, M J</creatorcontrib><creatorcontrib>Lopez Pais, J</creatorcontrib><creatorcontrib>Izquierdo Coronel, B</creatorcontrib><creatorcontrib>Galan Gil, D</creatorcontrib><creatorcontrib>Alcon Duran, B</creatorcontrib><creatorcontrib>Awamleh Garcia, P</creatorcontrib><creatorcontrib>Moreno Vinues, C</creatorcontrib><creatorcontrib>Gorriz Magana, J</creatorcontrib><creatorcontrib>Fraile Sanz, A</creatorcontrib><creatorcontrib>Alonso Martin, J J</creatorcontrib><collection>CrossRef</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Espinosa Pascual, M J</au><au>Lopez Pais, J</au><au>Izquierdo Coronel, B</au><au>Galan Gil, D</au><au>Alcon Duran, B</au><au>Awamleh Garcia, P</au><au>Moreno Vinues, C</au><au>Gorriz Magana, J</au><au>Fraile Sanz, A</au><au>Alonso Martin, J J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>P882Predictors of myocardial infarction with non-obstructive coronary arteries (MINOCA)</atitle><jtitle>European heart journal</jtitle><date>2019-10-01</date><risdate>2019</risdate><volume>40</volume><issue>Supplement_1</issue><issn>0195-668X</issn><eissn>1522-9645</eissn><abstract><![CDATA[Abstract Introduction Increasing knowledge about MINOCA can improve its diagnosis and treatment. The aim of this study is to determine the predictors of MINOCA in the initial assessment of myocardial infarction (MI). Methods From 1 January 2016 to 31 December 2018, we carried out an analytical and observational study including all patients admitted to our hospital with MI and underwent coronary angiography. According to the definitions of 2016 ESC Position Paper on MINOCA, we classified the patients in two groups: infarction with obstructive coronary artery disease (MICAD) and MINOCA. We analyzed demographic, clinical, laboratorial and angiographic features. To determine MINOCA independent predictors, a multivariate analysis with logistic regression was carried out in those variables with a statistical signification lower than p<0.01 in the univariate analysis. Results During this 3-year period, 109 patients admitted with MI fully fit the 2016 ESC criteria of MINOCA. The table shows the results regarding our findings. Patients with MINOCA compared to those with MICAD, were younger and with fewer risk factors. Moreover MINOCA was found to be more frequent in women than men. More specifically, MINOCA patients more frequently had a previous history of psychiatric illnesses. They also suffered from higher stress levels either acute or chronic. Inflammatory condition rates were more than two-times higher in the MINOCA group and presented lower levels of troponine. After multivariate analysis, only female patients, inflammatory disorders, stress levels, and lower levels of hemoglobin and troponine, remained independent predictors of MINOCA. Univariate analysis Multivariate analysis MINOCA MICAD P Odds Ratio 95% CI P Female patients 51,4% 21,8% <0.01 2.1 1.12–4.09 0.021 Smokers 41.9% 69.2% <0.01 0.5 0.3–1.02 0.059 Psychiatric disease 22.9% 10.7% <0.01 0.97 0.45–2.08 0.952 Emotional stress 65.9% 34.5% <0.01 3.4 1.81–6.36 <0.01 Autoimmune disorders 34.9% 14.1% <0.01 2.73 1.45–5.1 0.002 Heart rate at admission (lpm) 89±27.1 79±17.7 <0.01 1.92 0.95–3.86 0.068 Troponine I peak (ng/ml) 5.52±8.8 34.05±61.8 <0.01 2.32 1.16–4.65 0.017 Hb (g/dl) 13.5±2.13 14.17±1.83 0.03 2.89 1.48–5.6 0.02 Conclusion MINOCA patients differ in some ways to those patients with MICAD. Being a woman, recognizing emotional stress, having autoimmune disorders and lower levels of troponine and Hb might predict having a MINOCA.]]></abstract><pub>Oxford University Press</pub><doi>10.1093/eurheartj/ehz747.0479</doi></addata></record>
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