Prevalence of thrombophilia and antiphospholipid syndrome in myocardial infarction with non-obstructive coronary arteries and cryptogenic stroke

The role of thrombophilia in myocardial infarction without obstructive coronary artery disease (MINOCA) is unclear.

We investigated thrombophilic factors in patients with MINOCA in comparison with a group of patients with cryptogenic stroke.

92 patients (mean age: 52.5 years) were evaluated at least 2 months after hospitalization for I MINOCA. The control group was age-comparable patients with cryptogenic stroke (n=90) and the group of patients with myocardial infarction with obstructive coronary artery disease (MI-CAD) (n=80). Thrombophilia screening included hereditary thrombophilia (factor V Leiden, prothrombin mutation G20210A, protein C, protein S or antithrombin deficiency), antiphospholipid syndrome (APS), along with factor VIII >150%, homocysteine ≥15 μm and lipoprotein (a) ≫30 mg/dl.

Compared to cryptogenic stroke, in the MINOCA group, men were more common among patients (56.2 vs. 33.3%, P<0.001), obesity was more common among risk factors (31.5 vs. 16.9%, P=0.014), smoking (54.2 vs. 39.7%, P=0.042), as well as a burdened family history (18.4 against 7.0%, P=0.004). Hereditary thrombophilia occurred in 25.8% of patients with MINOCA and in 17.1% with cryptogenic stroke (P=0.17). APS was found in 15.5% of MINOCA. APS was diagnosed less frequently in patients with NSTEMI, (2.9 versus 21.3% P=0.002) and in patients with MINOCA aged ≤55 years (4.1 versus 36.3% for the elderly, P=0.005).

In patients with MINOCA, there is a high prevalence of thrombophilia, including APS, similar to cryptogenic stroke. Our first comprehensive study of thrombophilia in MINOCA confirms its clinical significance.

Type of funding source: None