MINOCA: The caveat of absence of coronary obstruction in myocardial infarction

Highlights • The MINOCA prevalence is 5.2% in the total ACS population. • MINOCA occurs predominantly in the NSTE-ACS population and in females. • MINOCA show an ‘intermediate’ risk profile with mortality rates in between those of SV-ACS and MV-ACS.
Aims Whether patients with MINOCA (myocardial infarction with non-obstructive coronary arteries) have better outcomes than patients with obstructive coronary artery disease remains contradictory. The current study focussed on the clinical profile and prognosis of MINOCA patients. Methods and results We performed a retrospective analysis of patients with acute coronary syndrome (ACS) admitted to the Isala hospital in Zwolle, the Netherlands, between 2006 and 2014. A total of 7693 patients were categorized into three groups: MINOCA, single-vessel obstructive ACS (SV-ACS), and multi-vessel obstructive ACS (MV-ACS). MINOCA patients (5.2% of the total population) were more likely to be female (51.5% vs. 30.3% and 26.0% in SV-ACS and MV-ACS, respectively, p