Clinical and Laboratory Parameters and Complication Rates In Patients With Myocardial Infarction Without Obstructive Coronary Artery Disease

Aim. To evaluate clinical, anamnestic and laboratory data and the incidence rate of complications in patients with myocardial infarction (MI) without obstructive coronary artery (CA) disease.

Material and methods. This study included 158 patients with MI without obstructive CA disease (main group), 150 patients with MI and obstructive CA disease (comparison group), and 55 patients without documented ischemic heart disease (IHD) (control group). Clinical and anamnestic data, carbohydrate and lipid metabolism, concentrations of high-sensitivity troponin and C-reactive protein (CRP) were evaluated, and electrocardiography, Holter electrocardiogram monitoring, echocardiography, and coronary angiography were performed for all patients.

Results. The incidence rate of MI without obstructive CA disease was 1.9%, which was in general consistent with international data. Patients with MI without obstructive CA disease were somewhat younger than patients of the comparison group. Traditional risk factors, such as arterial hypertension (AH), acute cerebrovascular disease, diabetes mellitus (DM), and obesity were more frequently observed in patients with MI and obstructive CA disease, but the body weight index was significantly higher in MI patients without obstructive CA disease. The multivariate regression analysis identified the most significant factors associated with the development of MI in the group without obstructive CA disease: lipid metabolism disorders, AH, DM, male gender, smoking, and family history of IHD. Patients with MI without obstructive CA disease had a lower troponin level but a higher CRP level. Patients with MI without obstructive CA disease had a higher left ventricular (LV) ejection fraction (EF); acute heart failure (AHF), acute LV aneurism, and arrhythmias were the most frequent complication in this group.

Conclusion. Patients with MI without obstructive CA disease had a higher LV EF, and their most frequent complications were AHF, acute LV aneurism, and arrhythmias.

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