Pharmacological therapy for the prevention of cardiovascular events in patients with myocardial infarction with non-obstructed coronary arteries (MINOCA): Insights from a multicentre national registry
| Autor: | Denise Zaffalon, Roberto Bonmassari, Monica Verdoia, Giuseppe De Luca, Alessia Bonci, Juan Carlos Kaski, Andrea Boscutti, Francesco Cassadonte, Fabio Infusino, Federico Guerra, Massimo Mancone, Stefano Coiro, Alessandro Capucci, Francesco Fedele, Giuseppe Ambrosio, Francesco Bianco, Antonio Dello Russo, Giuseppe Ciliberti, Isabella Tritto, Marco Merlo, Rocco Gioscia, Sabina Gallina, Gianfranco Sinagra, Filippo Zilio, Marco Vatrano, Giulia Stronati |
|---|---|
| Přispěvatelé: | Ciliberti, G., Verdoia, M., Merlo, M., Zilio, F., Vatrano, M., Bianco, F., Mancone, M., Zaffalon, D., Bonci, A., Boscutti, A., Infusino, F., Coiro, S., Stronati, G., Tritto, I., Gioscia, R., Dello Russo, A., Fedele, F., Gallina, S., Cassadonte, F., Ambrosio, G., Bonmassari, R., De Luca, G., Sinagra, G., Capucci, A., Kaski, J. C., Guerra, F. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Registrie
Acute coronary syndrome medicine.medical_specialty Prognosi Acute coronary syndromes Acute myocardial infarction MINOCA Pharmacological therapy Prognosis Aged Angiotensin Receptor Antagonists Angiotensin-Converting Enzyme Inhibitors Cohort Studies Female Humans Italy Registries Retrospective Studies Coronary Vessels Myocardial Infarction 030204 cardiovascular system & hematology acute coronary syndromes acute myocardial infarction pharmacological therapy prognosis 03 medical and health sciences 0302 clinical medicine Retrospective Studie Internal medicine medicine Clinical endpoint 030212 general & internal medicine Myocardial infarction Stroke Coronary Vessel Aspirin business.industry Angiotensin Receptor Antagonist Angiotensin-Converting Enzyme Inhibitor Retrospective cohort study medicine.disease Heart failure Cohort Studie Cardiology and Cardiovascular Medicine business Human Cohort study medicine.drug |
| Popis: | Aims To assess the effect of pharmacological therapy on long-term prognosis of patients with MINOCA. Methods and results In this retrospective multicentre cohort study involving 9 Hub Hospitals across Italy we enrolled consecutive patients 18 years and older with diagnosis of MINOCA discharged from 1st March 2012 to 31st March 2018. Data on baseline characteristics and pharmacological therapy at discharge (ACEI/ARB, angiotensin-converting enzyme inhibitors/angiotensin receptor antagonists; ASA, acetylsalicylic acid; beta-blockers; CCB, calcium-channel blockers; DAPT, dual anti-platelet therapy; statins), were collected systematically. The primary endpoint (PE) of the study was a composite of all cause death or acute myocardial infarction or acute coronary syndrome or heart failure leading to hospitalization or stroke. A total of 621 patients were included (mean [SD] age 65.1 [13.9] years; 344 [55.4%] female), of whom 106 (17.1%) experienced PE, including 27 patients (4.3%) who died. Multivariable analysis, after correction for all baseline differences, showed a significant association between pharmacological therapy at discharge and an increased risk of PE for aspirin (HR[95%CI] = 2.47[1.05–5.78], adjusted p = 0.04), whereas beta-blockers were associated with a significant benefit (HR[95%CI] = 0.49 [0.31–0.79], adjusted p = 0.02). Conclusion The use of beta-blockers was significantly associated to a less frequent occurrence of adverse outcomes at long-term follow-up among patients with MINOCA, whereas ASA displayed a potentially harmful impact on prognosis. The findings in the study may be relevant for the design of future studies which should take into account possible heterogeneity among MINOCA patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|