Background

Several data have been published about the baseline characteristics and outcome of patients suffering from myocardial infarction with non-obstructive coronary disease (MINOCA). However, a systematic analysis of in-hospital complications are limited.

Methods

Clinical data were screened for patients admitted at the Bergmannsheil University Medical Center from 2010-to 2021. All patients suffering from myocardial infarction with no obstructive coronary artery disease (MINOAC) were included. Among 12000 cases 374 patients fulfilled the criteria.

Results

374 patients (62.9+15.9, 49.5% males) were identified in the clinic database. 68% suffered from arterial hypertension, 26.5% dyslipidemia, 17.4% diabetes mellitus and 15.1% atrial fibrillation. Patients were admitted due to angina pectoris 61.6% or dyspnea 44.4%.  Newly diagnosed atrial fibrillation was documented in 3.8%. The TNT-level was at admission 2.2+8.1 U/L, BNP 555.8+1041.6 pg/ml, Creatin-phasphatkinase 286.9+515.7 U/L. At admission the left ventricular ejection fraction was 50.8+14.4% and 27.7% showed a left ventricular hypertrophy. 11.5% of patients suffered from malignant arrhythmias including (AV-Block II Mobitz, AV-Block III, asystole, ventricular tachycardia, ventricular fibrillation and torsade de pointes), 7.5% from cardiopulmonary resuscitation, 0.8% from left ventricular thrombus formation, 2.7% pulmonary edema, 2.7% cardiogenic shock and subsequently 7.8% invasive mechanical ventilation and 0.3% stroke. 2.7% suffered from in-hospital mortality among them 1.9% related to cardiac causes. Predictors of in-hospital complications were age, sclerotic coronary arteries and atrial fibrillation.

Conclusions

MINOCA patients suffer from several in-hospital complications despite the not relevantly reduced left ventricular ejection fraction. A long-term follow-up is required to identify high risk groups.