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Thrombophilia and Myocardial Infarction with Non-Obstructive Coronary Arteries

1Sechenov First Moscow State Medical University, Department of Medicine, Moscow, Russian Federation, 2Russian Association on Thrombosis, Haemostasis and Vascular Pathology, Moscow, Russian Federation, 3Sechenov First Moscow State Medical University, Department of Medical Informatics and Statistics, Moscow, Russian Federation, 4Shemyakin and Ovchinnikov Institute of Bioorganic Chemistry Russian Academy of Sciences, Department of Genomic Analysis and Correction Group of the Laboratory of Biotechnology, Moscow, Russian Federation

Abstract Number: PB0006

Meeting: ISTH 2020 Congress

Theme: Arterial Thromboembolism » Acute Coronary Syndromes

Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is rare condition and occurs in 5% to 10% of all patients with myocardial infarction (MI). The underlying pathophysiological mechanisms are poorly understood, although several different mechanisms have been proposed, including plaque disruption, spasm, thromboembolism, dissection, other reasons. The presence of inherited thrombotic disorders could influence the risk of MINOCA, according to studies about 14% thrombophilia is found in patients with MINOCA.

Aims: The aim of this study is to investigate the impact of thrombophilia on the risk of MINOCA.

Methods: MI was diagnosed by significant elevation of a cardiac biomarker and new ST/T changes, qualitative coronary angiography findings to allow determination of the presence/absence of obstructive coronary artery disease. MINOCA was defined as the presence of MI criteria in the absence of obstructive coronary artery disease (ie, no epicardial vessel with a stenosis ≥50% on angiography). The study involved 26 patients with MINOCA (6 females and 20 males, mean age 46.69 years±12.99) and 35 patients with MI with obstructive coronary arteries (25 males and 10 females, 64.00 years±11.97). All subjects were recruited to the study during their stay in the hospital. 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 patient younger than 40 years (p = 0.002). Factor V Leiden G1691A increase the risk of MINOCA in 2.5 (CI – 1.8 – 3.3), p = 0.029. Prothrombin G20210A, MTHFR C677T polymorphism, PAI-1(SERPIN1) 4G/5G polymorphism also increase the risk of MINOCA, but it was no significant.

Conclusions: Previous results of our work indicate influence of Factor V Leiden G1691A on the risk of MINOCA, especially in young person.

To cite this abstract in AMA style:

Golub A, Bokarev I, Popova L, Khlevchuk T, Kanevskaia M, Kondrateva T, Aksenova M, Gerasimov A, Patrushev L, Kovalenko T, Belenkov Y. Thrombophilia and Myocardial Infarction with Non-Obstructive Coronary Arteries [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/thrombophilia-and-myocardial-infarction-with-non-obstructive-coronary-arteries/. Accessed September 22, 2023.

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