Coronary slow flow is not an adverse prognostic factor in MINOCA patients in the 5-year follow-up

P. Buller, Adam Kern, Maciej Tyczyński, Wojciech Rosiak, Wojciech Figatowski, R. Gil, J. Bil
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Abstract

Introduction: The research aimed to compare the characteristics and outcomes of myocardial infarction with non-obstructive coronary arteries (MINOCA) patients with coronary slow flow (CSF) vs. normal coronary flow (no CSF) in a 5-year follow-up. Material and methods: Between 2010–2015 were identified 111 patients as having final MINOCA diagno - sis and available calculated corrected TIMI frame count (cTFC). CSF was defined as cTFC greater than 27 frames per second in any of the three coronary arteries. The primary endpoint was the 5-year major adverse cardiovascular events rate, defined as cardiac death, myocardial infarction, or hospitalization due to angina. Results: The mean cTFC was 28.9 ± 6.1 frames per second (median: 28, IQR 24–33; min-max: 19–58). 62 (55.9%) patients had normal coronary flow, and 49 (44.1%) had CSF. Patients did not differ in sex (fe - males no CSF vs. CSF: 58% vs. 61%, p = 0.7) or age (63 ± 15 years vs. 63 ± 13 years, p = 0.8). Patients with CSF characterized higher rates of chronic kidney disease (0 vs. 8.2%, p = 0.035). No statistically significant difference was observed for any of the analysed points. MACE rates for no CSF vs. CSF were 9.6% vs. 14.3% (HR 0.80, 95% CI 0.28–2.96, p = 0.7), respectively. Conclusions: CSF was not associated with a higher risk of adverse events among MINOCA patients at five years.
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在5年随访中,冠状动脉慢血流不是MINOCA患者的不良预后因素
前言:本研究旨在通过5年随访,比较非阻塞性冠状动脉(MINOCA)患者冠脉慢流(CSF)与正常冠脉流(无CSF)的心肌梗死的特点和结局。材料和方法:2010-2015年间,确定了111例最终MINOCA诊断的患者和可计算的校正TIMI帧计数(cTFC)。CSF被定义为在三条冠状动脉中任何一条的cTFC大于27帧/秒。主要终点是5年主要不良心血管事件发生率,定义为心源性死亡、心肌梗死或因心绞痛住院。结果:平均cTFC为28.9±6.1帧/秒(中位数:28,IQR 24-33;min-max: 19-58)。62例(55.9%)冠脉血流正常,49例(44.1%)有脑脊液。患者在性别(男性无脑脊液vs.脑脊液:58% vs. 61%, p = 0.7)和年龄(63±15岁vs. 63±13岁,p = 0.8)上没有差异。CSF患者的慢性肾脏疾病发生率较高(0比8.2%,p = 0.035)。在任何分析点上都没有观察到统计学上的显著差异。无脑脊液组和脑脊液组的MACE率分别为9.6%和14.3% (HR 0.80, 95% CI 0.28-2.96, p = 0.7)。结论:脑脊液与MINOCA患者5年不良事件的高风险无关。
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