Acute Myocardial Infarction with Non-Obstructive Coronary Arteries ? Stratifying the Risk of a ?new? Clinical Entity using an ?Old? Tool

Autores da FMUP

• Davide Maurício Costa Carvalho

  Autor

Participantes de fora da FMUP

• Ca?oilo, M
• Afreixo, V
• Bastos, JM
• Ferraz, L
• Vieira, M
• Santos, L
• Gonzaga, A
• Ferreira, R
• Adrega, T
• Faustino, A
• Briosa, A

Unidades de investigação

• Medicina

Abstract

Background: Some of the patients admitted for acute myocardial infarction have non-obstructive coronary artery disease (MINOCA). Their prognosis is not always benign, making it necessary the development of tools for risk stratification of these patients. Objectives: To describe the characteristics of a sample of patients admitted for suspected MINOCA and to evaluate the prognostic value of GRACE score in this population. Methods: This was a retrospective, observational, single-center, cohort study involving 56 consecutive patients with MINOCA. During one-year follow-up, patients were assessed for mortality and major adverse cardiovascular events (MACE) ? a composite of all-cause mortality and hospitalization due to acute myocardial infarction, heart failure, ischemic stroke, and acute limb ischemia. Statistical analysis was performed using a non-parametric approach, with the Mann-Whitney U test for quantitative variables and ROC curves for assessing the discriminatory power of the Grace score in predicting cardiovascular events. The level of significance was set at 5%. Results: Of the 56 MINOCA patients included in the study (median age 67 years), 55.4% were female. During the one-year follow-up, mortality rate was 5.5% and 9.1% of patients had MACE. A higher GRACE score was associated with mortality (p = 0.019; AUC 0.907; 95%CI 0.812?1.000; cut off 138) and MACE (p =0.034; AUC 0.790; 95%CI 0.632?0.948; cutoff 114). Conclusion: The definition of MINOCA includes various diagnoses and prognoses, and the GRACE score is useful for risk stratification of patients with this condition. ? 2021, Sociedade Brasileira de Cardiologia. All rights reserved.