Frequency and Classification of Myocardial Infarction with Non-Obstructive Coronary Arteries Among Young Adults Presenting with Acute Myocardial Infarction in Multan District, Pakistan
DOI:
https://doi.org/10.68279/xagsrc95Keywords:
Acute Myocardial Infarction; MINOCA; Non-Obstructive Coronary Arteries; Young Adults; Coronary Vasospasm; Microvascular Dysfunction; Risk Factors.Abstract
Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous clinical entity that is particularly relevant in younger adults and women. Accurate differentiation from obstructive myocardial infarction and identification of the underlying mechanism are important because clinical presentation, diagnostic pathways, and management may differ substantially. Objective: To characterize the frequency, etiological distribution, clinical profile, treatment patterns, and short-term outcomes of working MINOCA compared with obstructive myocardial infarction among young adults aged 18–45 years. Methods: An analytical cross-sectional framework was applied to a dataset of 290 acute myocardial infarction observations classified according to coronary angiographic findings. Working MINOCA was defined by the absence of ≥50% stenosis in any major epicardial coronary artery. Demographic, cardiovascular, psychosocial, clinical, treatment, and in-hospital outcome variables were compared between groups. Binary logistic regression was used to examine factors associated with working MINOCA classification. Results: Working MINOCA accounted for 43 of 290 observations (14.8%). Female sex was more frequent in the MINOCA group than in the obstructive myocardial infarction group (44.2% vs. 21.5%, p=0.001). MINOCA was also characterized by lower body mass index, less current smoking, less frequent ST-segment elevation, lower peak troponin I, and higher perceived-stress scores. Plaque disruption and coronary vasospasm were the most frequent assigned mechanisms. Female sex was associated with working MINOCA classification in multivariable analysis (adjusted OR 2.94; 95% CI 1.46–5.92; p=0.003). Conclusion: Working MINOCA represented a clinically distinct subgroup within the analytical dataset. Mechanism-oriented classification and broader clinical profiling may improve the structured evaluation of young adults presenting with myocardial infarction and non-obstructive coronary arteries
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Copyright (c) 2026 Syed Ali Akbar Rizvi, Saadat Hussain Khan, Tehzeeb Zahra, Samina Badar, Khadeja Yousaf, Muhammad Asif, Ume Habiba, Qasim Zia (Author)
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