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
Copyright © 2020 Elsevier B.V. All rights reserved..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:327 |
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| Enthalten in: |
International journal of cardiology - 327(2021) vom: 15. März, Seite 9-14 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ciliberti, Giuseppe [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 28.05.2021 Date Revised 28.05.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2020.11.040 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM31809052X |
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| 100 | 1 | |a Ciliberti, Giuseppe |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Pharmacological therapy for the prevention of cardiovascular events in patients with myocardial infarction with non-obstructed coronary arteries (MINOCA) |b Insights from a multicentre national registry |
| 264 | 1 | |c 2021 | |
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| 500 | |a Date Completed 28.05.2021 | ||
| 500 | |a Date Revised 28.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier B.V. All rights reserved. | ||
| 520 | |a AIMS: To assess the effect of pharmacological therapy on long-term prognosis of patients with MINOCA | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Acute coronary syndromes | |
| 650 | 4 | |a Acute myocardial infarction | |
| 650 | 4 | |a MINOCA | |
| 650 | 4 | |a Pharmacological therapy | |
| 650 | 4 | |a Prognosis | |
| 650 | 7 | |a Angiotensin Receptor Antagonists |2 NLM | |
| 650 | 7 | |a Angiotensin-Converting Enzyme Inhibitors |2 NLM | |
| 700 | 1 | |a Verdoia, Monica |e verfasserin |4 aut | |
| 700 | 1 | |a Merlo, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Zilio, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Vatrano, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Bianco, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Mancone, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Zaffalon, Denise |e verfasserin |4 aut | |
| 700 | 1 | |a Bonci, Alessia |e verfasserin |4 aut | |
| 700 | 1 | |a Boscutti, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Infusino, Fabio |e verfasserin |4 aut | |
| 700 | 1 | |a Coiro, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Stronati, Giulia |e verfasserin |4 aut | |
| 700 | 1 | |a Tritto, Isabella |e verfasserin |4 aut | |
| 700 | 1 | |a Gioscia, Rocco |e verfasserin |4 aut | |
| 700 | 1 | |a Dello Russo, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Fedele, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Gallina, Sabina |e verfasserin |4 aut | |
| 700 | 1 | |a Cassadonte, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Ambrosio, Giuseppe |e verfasserin |4 aut | |
| 700 | 1 | |a Bonmassari, Roberto |e verfasserin |4 aut | |
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| 700 | 1 | |a Kaski, Juan Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Guerra, Federico |e verfasserin |4 aut | |
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