Sex differences in patients with working diagnosis of myocardial infarction with nonobstructive coronary arteries (MINOCA)

Milewski, Marek; Desperak, Aneta; Koźlik, Maciej; Bujak, Marta; Gierlotka, Marek; Milewski, Krzysztof; Wita, Krystian; Kalarus, Zbigniew; Fluder-Włodarczyk, Joanna; Buszman, Pawel E.; Piegza, Jacek; Mamas, Mamas A.; Wojakowski, Wojciech; Gasior, Pawel

Abstract

Myocardial infarction with nonobstructive coronary arteries (MINOCA) constitutes 3–15% of all acute myocardial infarctions. Women are more frequently diagnosed with MINOCA, although the influence of sex on long-term outcomes is still unclear. In this study we aimed to compare sex-based differences in baseline characteristics and clinical outcomes in patients with suspected MINOCA. We have retrospectively analyzed 6063 patients diagnosed with MINOCA (3220 females and 2843 male patients) from combined 3 large polish registries (PL-ACS, SILCARD and AMI-PL). Male patients were significantly younger (63 (55–74) vs. 71 (61–79) years, p < 0.05) and less frequently diabetic (20.1% vs. 24.1%, p < 0.05). Mortality was significantly higher in male population (11.8% vs. 10.2%, p < 0.05 at 1 year and 17.6% vs. 15.0%, p < 0.05 at 3 years). Male sex was an independent predictor of both mortality (HR = 1.29; CI 1.11–1.51; p < 0.05) and myocardial infarction (HR = 1.39; CI 1.1–1.75, p < 0.05) at 3 years follow-up. All-cause readmission rates were similar in male and female patients both at 1 year (46.0% vs. 44.4, p = 0.2) and 3 years follow-up (56.4% vs. 56.5%, p = 0.93). However, cardiovascular readmissions were more prevalent in male patients at both timepoints (33.9% vs. 29.10%, p < 0.05 at 1 year, and 41.0% vs. 37.6%, p < 0.05 at 3 years). This large-scale registry-based analysis demonstrated higher 3 years rates of adverse events, including death and MI among male patients with suspected MINOCA.

Citation

Milewski, M., Desperak, A., Koźlik, M., Bujak, M., Gierlotka, M., Milewski, K., …Gasior, P. (in press). Sex differences in patients with working diagnosis of myocardial infarction with nonobstructive coronary arteries (MINOCA). Scientific Reports, 15(1), 1-11. https://doi.org/10.1038/s41598-025-87121-5

• Journal Article Type: Article
• Acceptance Date: Jan 22, 2025
• Online Publication Date: Jan 22, 2025
• Deposit Date: Jan 30, 2025
• Publicly Available Date: Jan 30, 2025
• Journal: Scientific Reports
• Electronic ISSN: 2045-2322
• Publisher: Nature Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 1
• Article Number: 2764
• Pages: 1-11
• DOI: https://doi.org/10.1038/s41598-025-87121-5
• Public URL: https://keele-repository.worktribe.com/output/1051586