CLINICAL AND ANGIOGRAPHIC PROFILE OF MYOCARDIAL INFARCTION WITH NONOBSTRUCTIVE CORONARY ARTERIES (MINOCA).

Background: Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) remains a challenge in the clinical practice. Objective: This study has been designed to evaluate the prevalence, risk factors, clinical and angiographic profile of patients with MINOCA. Methods: Two seventy four consecutive patients with Acute Myocardial infarction got admitted during the period Between March 2017- February 2019 were included in the study .They were classified in to MINOCA and MICAD group and their demographic, clinical, laboratory parameters, and angiographic features were compared. Result: Twenty-Five of 274 patients admitted for acute myocardial infarction (MI) were classified as MINOCA (prevalence 9.1%). Patients with MINOCA were younger (46.1 vs 52.4 years, p <0.001) and the proportion of women was higher (42.5% vs 18.7%, p =0.03) than the obstructive group. The MINOCA group had less cardiovascular risk factors (Diabetes 19.3% vs 31.1%, Hypertension 17.3% vs 37.7% and smoking 45.3% vs 61.3%). The presence of ST elevation MI was less (23.0% vs 47.9%) among MINOCA group. The prevalence of risk factors like dyslipidemia (36% vs 38.7%), obesity(8.0% vs 9.5%),family history of CAD (8.0% vs 8.0%) and presence of peripheral artery disease (4.0% vs 1.0%)were similar in both the groups. Angiographic findings among the MINOCA group were recanalised and minimal CAD in 50.6%, normal coronaries in 24%, slow flow in 12% , coronary spasm in 5.3%. Myocardial bridging, coronary anomalies and coronary thrombus contributed 2.7% each. Conclusions: MINOCA was more common in younger age group, females and patients with NSTEMI. Cardiovascular risk factors like Diabetes , Hypertension and smoking were less prevalent in MINOCA group and risk factors like dyslipidemia, obesity, family history of CAD and presence of Peripheral artery disease were similar in both the groups. In coronary angiography Recanalised and minimally obstructive lesion was found to be the commonest one followed by normal coronaries in MINOCA patients.