Do Chest Pain Characteristics in Patients with Acute Myocardial Infarction Differ between Those with and without Obstructive Coronary Artery Disease?

Sivabaskari Pasupathy, Sarena La, Rosanna Tavella, Christopher Zeitz, Matthew Worthley, Ajay Sinhal, Margaret Arstall, John F. Beltrame

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
23 Downloads (Pure)

Abstract

The universal definition of acute myocardial infarction (MI) requires both evidence of myocardial injury and myocardial ischaemia. In MINOCA (MI with non-obstructive coronary arteries), patients must fulfil this MI criteria, but is their chest pain similar to those who have MI with obstructive CAD (MICAD)? This study compares prospectively collected chest pain features between patients with MINOCA and MICAD. Utilising the Coronary Angiogram Database of South Australia (CADOSA), consecutive MI patients were categorized as MINOCA or MICAD based on angiographic findings. Chest pain data were collected via direct patient interviews by trained staff members. Of 6811 consecutive patients fulfilling a clinical MI diagnosis, 411 (6.0%) were MINOCA, and 5948 MICAD. The MINOCA patients were younger, more often female and had less cardiovascular risk factors than those with MICAD. There were no significant differences in chest pain characteristics between the MINOCA and MICAD cohorts in relation to pain location, quality, associated symptoms, or duration. In conclusion, MINOCA patients have chest pain characteristics that are indistinguishable from MICAD patients, suggesting that their pain is ischaemic in nature. Thus, in the presence of positive myocardial injury markers, ischaemic chest pain fulfils the universal criteria for MI, despite the absence of obstructive coronary artery disease.

Original languageEnglish
Article number4595
Number of pages9
JournalJournal of Clinical Medicine
Volume12
Issue number14
DOIs
Publication statusPublished - 10 Jul 2023

Keywords

  • chest pain
  • coronary angiography
  • MINOCA
  • myocardial infarction
  • myocardial infarction with non-obstructive coronary arteries

Fingerprint

Dive into the research topics of 'Do Chest Pain Characteristics in Patients with Acute Myocardial Infarction Differ between Those with and without Obstructive Coronary Artery Disease?'. Together they form a unique fingerprint.

Cite this