Características y seguimiento a largo plazo de pacientes con infarto agudo de miocardio con arterias coronarias sin obstrucciones significativas (MINOCA). Un estudio de cohortes (2015-2019)

Objective: to describe the characteristics of patients with acute myocardial infarction without obstructive coronary lesions (MINOCA), as well as their cardiovascular outcomes at 18 months. Materials and methods: ambispective cohort study that included patients who underwent coronary angiography after being diagnosed with acute myocardial infarction (AMI) between 2015 and 2019. The MINOCA group was selected, and outcomes such as readmissions and major cardiovascular events were obtained at 18 months. Results: data form 433 patients who met the inclusion criteria were obtained, of which 141 (33%) met the criteria for MINOCA. The most prevalent clinical manifestations were chest pain and anginal equivalents (62% and 62.4% respectively), The majority presented with non-ST elevation myocardial infarction (92.1%), with left ventricular ejection fraction (LVEF) ≥ 50% (42.6%). During the 18-month follow-up, data were obtained from 102 patients, of whom 22% had readmissions; 18% experienced reinfarction, mortality during the follow-up was 12% due to cardiovascular causes, and 36% due to all causes. Conclusions: a higher proportion of MINOCA was found compared to what is described in the literature, with a predominance of atypical clinical manifestations. Equally striking is the significant percentage of pre-infarctions and cardiovascular deaths during the follow-up of this cohort.