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The Hidden Risk of MINOCA: Prognosis Compared With Healthy Controls in a Prospective Analysis
Session:
Sessão de Posters 51 - Circulação pulmonar, pericárdio e cuidados agudos
Speaker:
Matilde Ferreira
Congress:
CPC 2026
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.14 Cardiovascular Disease in Special Populations - Other
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Matilde Ferreira; M. I. Mendonça; G. Abreu; F. Sousa; F. Escórcio Silva; M. Rodrigues; S. Freitas; E. Henriques; S. Borges; A. Drumond; A. C. Sousa; R. Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Introduction:</span></strong><span style="color:black"> Some studies showed that the prognosis for patients with Myocardial Infarction (MI) with No Obstructive Coronary Artery Disease (MINOCA) is more favourable compared to those with Obstructive Coronary Artery Disease (CAD). However, it has been proven to be worse than the general population. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="background-color:white"><span style="font-family:Calibri,sans-serif"><strong><span style="color:black">Objective:</span></strong><span style="color:black"> Evaluate the prognostic value of MINOCA compared with a general population without apparent CAD from a Southern European population.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> A single-centre, prospective, and observational cohort study was performed from January 2000 to December 2023 with a total of 1,524 individuals. Patients were considered MINOCA if their coronary angiogram was classified as zero by the Leaman score. All participants underwent clinical observation and a survey form including demographic and traditional risk factors was filled out, as well as biochemical analysis. The primary outcome was all-cause cardiovascular (CV) events [MI, revascularisation, heart failure, stroke, peripheral arterial disease (PAD) and death]. Cox regression analysis identified variables independently associated with CV events and assessed the risk (HR) in these populations. The Kaplan-Meier <span style="background-color:white"><span style="font-family:"Calibri",sans-serif"><span style="color:black">estimated event-free survival over time.</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> Of the 1,524 participants, 87 (5.7%) had MINOCA and 1,437 (94.3%) were normal individuals without symptomatic CAD. Among the 87 MINOCA patients, 14 (16.1%) had CV events, vs 108 (7.5%) in the normal group. The Kaplan-Meier indicated that patients with MINOCA had a worse event-free probability throughout follow-up period. Specifically, at the end of 15 years, the rate of event-free probability was 52.2% vs 88.7% for the normal group. After the Cox regression analysis, the risk of CV events for patients with MINOCA was approximately five times higher compared with the normal group (HR=4.7, 95% CI: 2.6-8.5; p<0.0001). The other variables identified as independently associated with CV events were male sex (p=0.018), age (p<0.0001), smoking (p=0.001) and hypertension (p=0.001).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> In this prospective cohort, patients with MINOCA had a substantially higher long-term risk of CV events than individuals without CAD. Event-free survival was markedly reduced, and MINOCA remained a strong independent predictor of adverse CV outcomes. These findings reinforce that MINOCA is not a benign condition and highlight the need for rigorous risk stratification and sustained secondary prevention in this population. </span></span></p>
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