جستجوی مقالات مرتبط با کلیدواژه "minoca" در نشریات گروه "پزشکی"

The coronary angiography results in a group of patients with myocardial infarction (MI) are normal or near-normal; which is diagnosed as myocardial infarction with non-obstructive coronary arteries (MINOCA). This study aimed to compare the mortality rate and risk factors between MINOCA and myocardial infarction with obstructive coronary artery (MI-CAD).

This retrospective cohort study was conducted from January 1, 2018, to December 31, 2019. A total of 679 patients admitted to Afshar Hospital in Yazd with a diagnosis of ST-elevation myocardial infarction (STEMI) from 2018-2019 who underwent primary Percutaneous Coronary Intervention (PCI) were enrolled in the study. Demographic, and clinical variables, ECG finding and one-year mortality, were extracted using MI registry data from the Yazd Cardiac Research Center.

The estimated frequency of MINOCA was 4.6%. Patients with MINOCA (
47.14±6.2) were younger than patients with MI-CAD (57.61±9.1) (P <0.0001). MINOCA patients (47.4±9.47) had a considerably greater left ventricular ejection fraction (LVEF) than MI-CAD patients (43.5±6.8) (P =0.018). The majority site of MI in MINOCA patients was located in the non-anterior wall (p <0.0001). A comparison of MINOCA and MI-CAD patients' one-year mortality revealed no significant difference (P =0.07).  

The prevalence of patients with MINOCA in Yazd was similar to other communities. Although these patients probably do not have a better prognosis, despite being younger and having better LV systolic function and lower CAD risk factors.

A 38-year-old man presented to the emergency department with ongoing chest pain. The patient had a sudden onset of central, crushing chest pain for 7 hours, with severity increasing in the last 2 hours. The symptoms were associated with sweating. He was a known case of hypertension and was on medication for the preceding 2 years. The patient was also prediabetic. His mother had hypertension and diabetes mellitus. There was no history of hypertension, diabetes mellitus, or cardiovascular disease in his siblings. On general examination, the patient had an O2 saturation level of 95%, a pulse rate of 110 beats per minute, and a blood pressure of 110/90 mm Hg. On systemic examination, no abnormality was detected. Additionally, the complete blood count, renal function tests, blood sugar random test, and electrolytes were within normal limits. Electrocardiography demonstrated an ST elevation in the inferolateral leads. He also had a CPK-MB level of 82 IU/L and a troponin level of 11.6 IU/L. Echocardiography revealed a hypokinetic left ventricular inferior wall. With a diagnosis of acute inferolateral wall myocardial infarction (MI), the patient was taken to the catheterization laboratory, where coronary angiography revealed normal coronary arteries. He was admitted to the CCU and was treated with aspirin, clopidogrel, low-molecular-weight heparin, atorvastatin, beta-blockers, anxiolytics, proton-pump inhibitors, and stool softeners. On the following day, cardiac magnetic resonance revealed curvilinear, confluent, and patchy subendocardial enhancement in the inferoposterior wall of the left ventricle. The features were compatible with MI. He was conservatively managed and was discharged on the fifth post-MI day.