Thrombophilia and Myocardial Infarction with Non-Obstructive Coronary Arteries
Myocardial infarction without obstructive coronary arteries (MINOCA) is rare condition and occurs in 5% to 25% of all patients with myocardial infarction (MI). The underlying pathophysiological mechanisms are poorly understood. The presence of inherited thrombotic disorders could influence the risk of MINOCA, according to studies about 14% thrombophilia is found in patients with MINOCA. Aim. The aim of this study is to investigate the impact of thrombophilia on the risk of MINOCA. Methods. MINOCA was defined as the presence of MI criteria in the absence of obstructive coronary artery disease (i.e., no epicardial vessel with a stenosis ≥50% on angiography). MI with obstructive coronary artery disease was defined as the presence of at least 1 stenosis ≥50%. The study involved 28 patients with MINOCA (10 females, mean age 43.11 years ± 9,45 and 18 males, 63.00 years ± 13.67) and 35 patients with MI with obstructive coronary arteries (the control group, 25 males, mean age 63.00 years ± 14.23 and 10 females, 72.5 years ± 11.96). For all patients genetic testing for inherited thrombophilia - Factor V Leiden G1691A, Prothrombin G20210A, MTHFR C677T polymorphism, PAI-1(SERPIN1) 4G/5G polymorphism - was performed by real-time PCR technique. Results. Study have shown that MINOCA was higher in younger patient (p = 0.002). Factor V Leiden G1691A increase the risk of MINOCA in 2.5 (CI - 1.8 - 3.3), p = 0.034. Prothrombin G20210A, MTHFR C677T polymorphism, PAI-1(SERPIN1) 4G/5G polymorphism also increase the risk of MINOCA, but it was no significant. Conclusion. Previous results of our work indicate influence of Factor V Leiden G1691A on the risk of MINOCA, especially in young.