996 INCIDENCE AND PREDICTORS OF HEART FAILURE DEVELOPMENT IN A COHORT OF PATIENTS WITH MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERIES

Abstract Background A higher risk of death and major cardiovascular events, including Heart Failure (HF), after a Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) has been described. In particular, HF negative impact not only on survival but also quality life. this context, strategies to identify subjects greater developing are needed. Aims To assess the incidence predictors subsequently MINOCA. Methods 461 suspected MINOCA from 2016 2021 were assessed. Acute myocarditis, Takotsubo syndromes, cardiomyopathies patients incomplete data excluded. The final cohort consisted 188 confirmed diagnosis. After mean follow-up 36±14.8 months, 20 (10.6%) had hospital readmission for HF. Demographic, clinical, laboratory, instrumental collected analyzed. Results None among demographic characteristics, factors or comorbidities showed correlation occurrences. Paroxysmal permanent atrial fibrillation was more frequent who developed (p .005), such as ST-elevation at onset .001). Higher glycemia admission correlated .012). regard, hyperglycemia could act direct toxic agent an indirect marker stress response. Cardiac troponin I (cTnI) peak, first cTnI measurement, significantly in (p<.001), confirming prognostic value troponin, even context. Concerning echocardiography, any wall motion abnormalities .037), lower ejection fraction (EF; p .046), especially if EF≤40% maximum diameter end-diastolic (p. 001) normalized volume (p<.001). Among cardiac magnetic resonance findings, occurred often (p<.001) transmural pattern late gadolinium enhancement (LGE), which resulted independent factor multivariate analysis (HR 15.32, 95% CI 5.13-45.75, p<.001). Finally, 32 (17%) affected by non-obstructive coronary arteries stenosis (i.e., <50%). This finding, re-infarction, associated development .004). Notably, 2 out 68 dismissed DAPT .010). our study beta-blockers, RAS inhibitors statins dismission reduced Nevertheless, low sample size forbids inferring conclusions about therapy. Conclusion MINOCA, several laboratory echocardiographic characteristics frequency Moreover, broader extent damage, testified cTnI, abnormalities, EF LGE, predict development. Further studies establish adequate programs therapy prevent progression these