Clinical characteristics, aetiological factors and long-term prognosis of myocardial infarction with an absolutely normal coronary angiogram; a 3-year follow-up study of 91 patients

摘要: Objectives The purpose of this study was to evaluate the clinical outcome a large cohort patients who suffered an acute myocardial infarction with absolutely normal epicardial coronary arteries at post-myocardial angiogram. aetiological and prognostic factors in population were also analysed. Background Few data exist concerning outcome, factors, angiographically arteries. Methods Ninety-one (34 females/57 males; mean age 50±13 years, range 24–78 years) admitted had angiogram performed 6·2±4 days (range 1–15 days) after infarction, defined by smooth contours no focal reduction (NC). Of 91 NC patients, 71 evaluated prospectively, alongside systematic search all reported literature. matched for age, sex, same period onset group artery stenosis (>50% diameter stenosis) 7·3±4 (SC). Results percent smokers similar between two groups; higher prevalence rates heart disease family history, obesity, hypertension, hypercholesterolaemia diabetes mellitus found SC ( P =0·043 0·0001). In NC, spasm 15·5%, congenital coagulation disorders 12·8%, collagen tissue 2·2%, embolization oral contraceptive use 1·1%. Left ventricular ejection fraction hospital discharge (60%±13%) than (55%±13%, =0·04). follow-up 35 months 1–100 months). Kaplan–Meier event-free survival, combined end-point as death, reinfarction, failure stroke 75% vs 50% <0·0001). Survival rate 94·5% compared 92% (ns). Univariate predictors events left =0·03), =0·02), =0·01), smoking =0·03). Using Cox multivariate analysis, independent long-term =0·003) =0·004). Conclusion Aetiological predominantly inherited disorder, can be detected only one third angiograms despite prospective population. Mortality are but morbidity is lower angiography those stenosis. predictive poor function diabetes.