LAUSR

INTRODUCTION The SARS-CoV-2 infection is associated with an increased risk of thromboembolic complications. OBJECTIVES We aimed to compare patient characteristics, and 12-month clinical outcomes of myocardial infarction with non-obstructive coronary arteries (MINOCA) before and during the COVID-19 pandemic. PATIENTS AND METHODS We retrospectively analyzed data of 51,734 patients with acute myocardial infarction registered in the nationwide PL-ACS database in 2019 and 2020, finally including 3,178 MINOCA patients. We compared baseline characteristics, management strategies, and 12-month clinical outcomes of MINOCA patients before (2019) and during (2020) the COVID-19 pandemic. RESULTS The MINOCA percentage was higher in 2019 than 2020 (6.3% vs. 5.9%, P = 0.03). The groups did not differ apart from the higher hypercholesterolemia rate before the pandemic (33.9% vs. 28.2%, P < 0.001). We observed in-hospital stroke more frequently during pandemic (0 vs. 0.3%, P = 0.01). However, other in-hospital complications were similar between groups. Most patients were discharged on aspirin (85.6%), beta-blocker (73.1%), angiotensin convertase enzyme inhibitor/angiotensin receptor blocker (70.2%), and statin (62.7%), but only 50.6% of patients received P2Y12 inhibitor. There was no statistical difference in 12-month all-cause mortality in patients with MINOCA before and during pandemic (total population 9.9%; 9.2% [2019] vs. 11.0% [2020], P = 0.09). CONCLUSIONS We observed a lower percentage of MINOCA cases and higher in-hospital stroke rates in MINOCA patients during the COVID-19 pandemic. The possible association between worse clinical outcomes of MINOCA patients during the COVID-19 pandemic and thromboembolic complications of SARS-CoV-2 infection needs further evaluation.