Frequency of Myocardial Infarction with Non-Obstructive Coronary Arteries in Patients With ST-Elevation Myocardial Infarction
DOI:
https://doi.org/10.61919/jhrr.v4i3.1984Keywords:
ST-segment elevation myocardial infarction; STEMI; myocardial infarction with non-obstructive coronary arteries; MINOCA; coronary angiography.Abstract
Background: Myocardial infarction with non-obstructive coronary arteries is an increasingly recognized clinical entity in which patients meet diagnostic criteria for myocardial infarction despite the absence of significant epicardial coronary stenosis on angiography. Although ST-segment elevation myocardial infarction is classically associated with acute coronary occlusion, a clinically important proportion of patients may present with STEMI and non-obstructive coronary arteries. Objective: To determine the frequency of myocardial infarction with non-obstructive coronary arteries among patients presenting with ST-segment elevation myocardial infarction. Methods: This cross-sectional study was conducted at the Department of Cardiology, Bolan Medical College/Hospital, Quetta, from 12 December 2023 to 14 June 2024. Patients presenting with ST-segment elevation myocardial infarction were enrolled after confirmation based on clinical presentation, electrocardiographic changes, and rise in cardiac enzymes. MINOCA was defined as myocardial infarction in the presence of less than 50% coronary stenosis on angiography, with exclusion of other diseases that could mimic myocardial infarction. Results: A total of 197 patients with STEMI were enrolled. Age ranged from 20 to 80 years, with a mean of 58.44 ± 10.85 years. MINOCA was identified in 32 patients, corresponding to a frequency of 16.2%, while 165 patients (83.8%) had obstructive coronary artery disease. Conclusion: MINOCA represents a clinically important subgroup among patients presenting with STEMI in this setting. Recognition of this entity is essential to support accurate diagnosis and appropriate downstream etiologic evaluation.
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