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Revista chilena de cardiología

On-line version ISSN 0718-8560


MALDONADO, Rodrigo et al. Clinical characteristics of patients with Acute Myocardial Infarction and no significant coronary artery lesions: GEMI Study (2011-1013). Rev Chil Cardiol [online]. 2014, vol.33, n.3, pp.165-172. ISSN 0718-8560.

Background: Acute myocardial infarction (AMI) is a consequence of disruption of coronary artery lesions leading to intracoronary thrombosis. Some patients with AMI show no significant lesions in a coronary angiography. Aim: To compare clinical characteristics, treatment and intrahospital mortality in patients with AMI with or without coronary artery lesions. Methods: 3194 patients from a clinical registry of AMI (GEMI) were included. AMI with no significant coronary artery lesions was defined as the abscense of any lesion http://fbpe/img/rchcardio/v33n3/signo.jpg50%. Results: 116 patients (3.6%) had no significant coronary lesions (NSL). Compared to the group with significant lesions (SL), they were younger (60±14 years vs 62±12 years, p<0,024) and the proportion of women was higher. NSL patients lower prevalence of hyperlipidemia (30,2% vs 42,8%, p<0.007), diabetes mellitus (14,7% vs 28,9%, p<0.001) and smoking habit (40,5% vs 61,3%, p<0.0001). NSL patients had a higher prevalence of non ST elevation AMI and lower levels of CK and CK-MB, as well as a lower ejection fraction. During hospitalization, NSL patients received aspirin, clopidogrel, betablockers, iv heparin and LMW heparin, less frequently tan SL patients. In contrast, they received calcium antagonists more frequently.  Conclusion: Patients with AMI and no significant coronary lesions have a lower prevalence of coronary artery disease risk factors. A greater frequency of non ST elevation AMI, lower indices of myocardial necrosis and better EF was also observed. The intensity of pharmacologic therapy was lower.

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