Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy

Abstract Objectives Our study aimed to determine the prevalence and prognosis of acute coronary syndrome with non-obstructive coronary artery (ACS-NOCA) in patients with hypertrophic cardiomyopathy (HCM). Methods and results We enrolled a total of 200 consecutive patients with HCM over a 139-month p...

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Autores principales:	Sarinya Puwanant, Angkawipa Trongtorsak, Chaisiri Wanlapakorn, Nattakorn Songsirisuk, Aekarach Ariyachaipanich, Smonporn Boonyaratavej
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/dbe4d21018f8493d82ee62ade22df081
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spelling	oai:doaj.org-article:dbe4d21018f8493d82ee62ade22df0812021-11-21T12:04:09ZAcute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy10.1186/s12872-021-02373-z1471-2261https://doaj.org/article/dbe4d21018f8493d82ee62ade22df0812021-11-01T00:00:00Zhttps://doi.org/10.1186/s12872-021-02373-zhttps://doaj.org/toc/1471-2261Abstract Objectives Our study aimed to determine the prevalence and prognosis of acute coronary syndrome with non-obstructive coronary artery (ACS-NOCA) in patients with hypertrophic cardiomyopathy (HCM). Methods and results We enrolled a total of 200 consecutive patients with HCM over a 139-month period from 2002 to 2013. The study found that 28 patients (14% of overall patients, 51% of patients with ACS) had ACS-NOCA, and 18 patients (9% of overall patients, 86% of patients with acute MI) had MINOCA as initial clinical presentations. The highest prevalence of non-obstructive coronary artery disease (NOCA) in patients with HCM was found in acute ST-elevation myocardial infarction (STEMI) (100%), followed by non-STEMI (82%), and unstable angina (29%). Patients with ACS-NOCA had more frequent ventricular tachycardia and lower resting left ventricular (LV) outflow tract gradients than those with no ACS-NOCA (p < 0.05 for all). The ACS-NOCA group had a lower probability of HCM-related death compared with the no ACS-NOCA group and the significant coronary artery disease (CAD) group (p-log-rank = 0.0018). Conclusions MINOCA or ACS-NOCA is not an uncommon initial presentation (prevalence rate 9–14%) in patients with HCM. NOCA was highly prevalent (51–86%) in patients with HCM presenting with ACS and had a favorable prognosis. Our findings highlight as a reminder that in an era of rapid reperfusion therapy, ACS in patients with HCM is not only a result of obstructive epicardial CAD, but also stems from the complex cellular mechanisms of myocardial necrosis.Sarinya PuwanantAngkawipa TrongtorsakChaisiri WanlapakornNattakorn SongsirisukAekarach AriyachaipanichSmonporn BoonyaratavejBMCarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENBMC Cardiovascular Disorders, Vol 21, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Sarinya Puwanant Angkawipa Trongtorsak Chaisiri Wanlapakorn Nattakorn Songsirisuk Aekarach Ariyachaipanich Smonporn Boonyaratavej Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy
description	Abstract Objectives Our study aimed to determine the prevalence and prognosis of acute coronary syndrome with non-obstructive coronary artery (ACS-NOCA) in patients with hypertrophic cardiomyopathy (HCM). Methods and results We enrolled a total of 200 consecutive patients with HCM over a 139-month period from 2002 to 2013. The study found that 28 patients (14% of overall patients, 51% of patients with ACS) had ACS-NOCA, and 18 patients (9% of overall patients, 86% of patients with acute MI) had MINOCA as initial clinical presentations. The highest prevalence of non-obstructive coronary artery disease (NOCA) in patients with HCM was found in acute ST-elevation myocardial infarction (STEMI) (100%), followed by non-STEMI (82%), and unstable angina (29%). Patients with ACS-NOCA had more frequent ventricular tachycardia and lower resting left ventricular (LV) outflow tract gradients than those with no ACS-NOCA (p < 0.05 for all). The ACS-NOCA group had a lower probability of HCM-related death compared with the no ACS-NOCA group and the significant coronary artery disease (CAD) group (p-log-rank = 0.0018). Conclusions MINOCA or ACS-NOCA is not an uncommon initial presentation (prevalence rate 9–14%) in patients with HCM. NOCA was highly prevalent (51–86%) in patients with HCM presenting with ACS and had a favorable prognosis. Our findings highlight as a reminder that in an era of rapid reperfusion therapy, ACS in patients with HCM is not only a result of obstructive epicardial CAD, but also stems from the complex cellular mechanisms of myocardial necrosis.
format	article
author	Sarinya Puwanant Angkawipa Trongtorsak Chaisiri Wanlapakorn Nattakorn Songsirisuk Aekarach Ariyachaipanich Smonporn Boonyaratavej
author_facet	Sarinya Puwanant Angkawipa Trongtorsak Chaisiri Wanlapakorn Nattakorn Songsirisuk Aekarach Ariyachaipanich Smonporn Boonyaratavej
author_sort	Sarinya Puwanant
title	Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy
title_short	Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy
title_full	Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy
title_fullStr	Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy
title_full_unstemmed	Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy
title_sort	acute coronary syndrome with non-obstructive coronary arteries (acs-noca) in patients with hypertrophic cardiomyopathy
publisher	BMC
publishDate	2021
url	https://doaj.org/article/dbe4d21018f8493d82ee62ade22df081
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Acute coronary syndrome with non-obstructive coronary arteries (ACS-NOCA) in patients with hypertrophic cardiomyopathy

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