Características clínicas, electrocardiográficas, angiográficas y niveles de troponina en pacientes con diagnóstico de MINOCA

Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is defined as a syndrome characterized by symptoms suggestive of ischemia with angiographically normal coronary arteries or with stenosis < 50%. The prevalence of MINOCA is 6-8% of patients diagnosed with AMI and is more fr...

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Autores principales: Villagra, M, Rojas, AB, García Brasca, D, Simondi, H
Formato: Artículo revista
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2022
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Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/39002
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Sumario:Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is defined as a syndrome characterized by symptoms suggestive of ischemia with angiographically normal coronary arteries or with stenosis < 50%. The prevalence of MINOCA is 6-8% of patients diagnosed with AMI and is more frequent in women with an average age of 55 years. Hospital mortality is 1.1%. Objective: To determine the clinical, electrocardiographic, angiographic characteristics and Troponin levels in patients with a MINOCA diagnosis. An observational, descriptive, prospective longitudinal study was carried out, which included patients of both sexes older than 18 years with a diagnosis of MINOCA who were admitted to the Coronary Unit of the Italian Hospital  of Cordoba in the period from July 2019 to February 2022. All patients underwent coronary angiography. Twenty-three patients diagnosed with MINOCA were included, of whom 65% (n=15) were female. The average age was 66 ± 11 years. The BMI was 28.94 ±4.26 kg/m2. The most frequent risk factors were dyslipidemia, AHT and DBT present in 78%, 74% and 26% respectively. 70% of the patients (n=16) had typical precordial pain. The most frequent electrocardiographic alterations were: BCRB, Ventricular Bigeminia, Anterior subepicardial ischemia and ST segment elevation in the Inferior and Anterolateral Face. The average values ​​of US Troponin in patients with a normal electrocardiogram were 0.07 ± 0.17 mg/dl vs 0.11 ± 0.10 mg/dl, when it was altered. Angiographically, no obstructions were found in 78% (n=18), muscle bridges in 17% (n=4), and only mild obstructions in 4% (n=1). In our patients diagnosed with MINOCA, the most frequent risk factors were dyslipidemia, HBP, DBT and overweight. Angiographically only mild coronary obstructions were found. US troponin levels were higher in patients with signs of ischemia and infarction on the electrocardiogram.