Abstract

Objective: The study aimed to evaluate the incidence of in-hospital infections and the clinical and laboratory factors that may contribute to infection development in patients with myocardial infarction and non-obstructive coronary arteries (MINOCA), and to compare these findings with those in patients with myocardial infarction due to obstructive coronary artery disease (MI-CAD).

Methods: In this prospective, single-center study, 1120 patients who presented with a preliminary diagnosis of acute myocardial infarction between October 2019 and October 2020 were evaluated; those with a history of coronary artery disease were excluded. A total of 104 patients who met the diagnostic criteria for MINOCA and 601 patients diagnosed with MI-CAD were included in the analysis. C-reactive protein (CRP) levels at admission, laboratory findings, and in-hospital complications were recorded. Multivariable logistic regression analysis was performed to identify factors associated with infection.

Results: C-reactive protein levels were significantly higher in the MINOCA group compared with the MI-CAD group (3.0 [1.0–9.0] mg/L vs. 0.7 [0.3–2.3] mg/L; p<0.001). Infection occurred in 21.2% of MINOCA patients and 11.3% of MI-CAD patients (p=0.010). In multivariable models, despite adjustment for CRP and other confounders, MINOCA remained an independent risk factor for infection (Model 3 OR 4.206; 95% CI: 2.040–8.670; p=0.001). Longer hospital stays, diabetes mellitus, and heart failure increased infection risk, whereas hyperlipidemia showed a protective association.

Conclusion: The higher infection rates observed in MINOCA patients suggest a distinct inflammatory and immunologic profile in this group. These findings indicate that infection risk should be considered in the clinical management of MINOCA and support the need for a comprehensive, multidisciplinary approach.

Keywords: MINOCA, infection, C-reactive protein, myocardial infarction, inflammation, prognosis