Health-related quality-of-life up to one year after myocardial infarction with non-obstructive coronary arteries

Abstract

Aims Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is a heterogenous group and previous studies indicate a decreased Health-Related Quality-of-Life (HRQoL) compared to patients with myocardial infarction with obstructive coronary artery disease and healthy individuals. However, longitudinal data are scarce. Therefore, the aim was to explore HRQoL among patients with MINOCA during a one-year period after the acute event in comparison to a group of healthy individuals and to describe HRQoL in patients with Takotsubo Syndrome (TTS). Methods and Results Patients with MINOCA were recruited from five hospitals in the Stockholm region (SMINC-2 study, clinical trials: NCT2318498). Patients responded to the HRQoL questionnaire RAND-36 at day 2–4, after 6- and 12 months, respectively. A sample of population-based individuals was used as a comparison group. A total of 142 MINOCA patients, (70% women) mean age 56 years, responded. A population-based sample of 317 volunteers (66% women), mean age 57 years. Patients with MINOCA scored lower than the comparison group in the domains role functioning physical, social functioning and role functioning emotional (P = 0.01–0.02) at 12 months. In these domains of HRQoL there was no improvement in MINOCA patients during 12 months follow-up. In the domains energy/fatigue vitality and emotional well-being the scores improved and were similar to the comparison group at 12 months. Patients with TS scored generally lower on RAND-36 than MINOCA patients without TTS. Conclusions Physical, social, and emotional functioning did not improve during the first year after MINOCA, indicating a need for increased follow-up including psychological support.

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

“…This may be explained by the lack of a consensus strategy for treatment of MINOCA due to the lack of prospectively designed randomised therapeutic clinical trials; hence, guidelines are based on observational studies and expert opinion [13]. Nevertheless, it is concerning that these MINOCA patients are undertreated, as there have been studies showing the impact on their health status [18]. In a study by Grozinsky et al [19], it was revealed that 25% of MINOCA patients have ongoing chest pain and a reduced quality of life at 12-month follow-up.…”