ST-segment elevation myocardial infarction with non-obstructive coronary arteries: Score derivation for prediction based on a large national registry

Acute myocardial infarction with ST-segment elevation (STEMI) and obstructive coronary arteries (MI-CAD) are treated with primary percutaneous coronary interventions (pPCI), while patients with STEMI and non-obstructive coronary arteries (MINOCA), usually require non-invasive therapy. The aim of the...

Full description

Saved in:

Bibliographic Details
Published in:	PloS one 2021-08, Vol.16 (8), p.e0254427-e0254427
Main Authors:	Jędrychowska, Magdalena, Siudak, Zbigniew, Malinowski, Krzysztof Piotr, Zandecki, Łukasz, Zabojszcz, Michał, Kameczura, Tomasz, Mika, Piotr, Bartuś, Krzysztof, Wańha, Wojciech, Wojakowski, Wojciech, Legutko, Jacek, Bartuś, Stanisław, Januszek, Rafał
Format:	Article
Language:	eng
Subjects:	Age Factors Aged Biology and Life Sciences Care and treatment Coronary Angiography Coronary heart disease Coronary Vessels - diagnostic imaging Coronary Vessels - physiopathology Female Heart attack Humans Male Medicine and Health Sciences Middle Aged Models, Cardiovascular Percutaneous Coronary Intervention Prognosis Registries Research and Analysis Methods Retrospective Studies Risk factors Sex Factors ST Elevation Myocardial Infarction - diagnostic imaging ST Elevation Myocardial Infarction - epidemiology ST Elevation Myocardial Infarction - physiopathology ST Elevation Myocardial Infarction - surgery
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Acute myocardial infarction with ST-segment elevation (STEMI) and obstructive coronary arteries (MI-CAD) are treated with primary percutaneous coronary interventions (pPCI), while patients with STEMI and non-obstructive coronary arteries (MINOCA), usually require non-invasive therapy. The aim of the study is to design a score for predicting suspected MINOCA among an overall group of STEMI patients. Based on the Polish national registry of PCIs, we evaluated patients between 2014 and 2019, and selected 526,490 subjects treated with PCI and 650,728 treated using only coronary angiography. These subjects were chosen out of 1,177,218 patients who underwent coronary angiography. Then, we selected 124,663 individuals treated with pPCI due to STEMI and 5,695 patients with STEMI and MINOCA. The score for suspected MINOCA was created using the regression model, while the coefficients calculated for the final model were used to construct a predictive model in the form of a nomogram. Patients with MINOCA differ significantly from those in the MI-CAD group; they were significantly younger, less often males and demonstrated smaller burden of concomitant diseases. The model allowed to show that patients who scored more than 600 points had a 19% probability of MINOCA, while for those scoring more than 650 points, the likelihood was 71%. The other end of the MINOCA probability scale was marginal for patients who scored less than 500 points (< .2%). Based on the created MINOCA score presented in the current publication, we are able to distinguish MINOCA from MI-CAD patients in the STEMI group.
ISSN:	1932-6203 1932-6203