Relationship Between COVID-19 and MINOCA: A Pilot Cross-Sectional Study

Abstract

Introduction: Evidence suggests that COVID-19 infection increases the likelihood of myocardial infarction with no
obstructive coronary arteries (MINOCA), particularly in females. This study hypothesizes that patients with COVID-19
and acute myocardial infarction (AMI) who underwent coronary angiography will have a higher proportion of MINOCA
than those with AMI without COVID-19.

Objective: This study aimed to assess if COVID-19 infection is associated with MINOCA in patients who underwent
coronary catheterization.

Methods: This was a single-center cross-sectional pilot study that gathered information using the electronic medical records
of a tertiary care institution between February 2020 and October 2021. Patients were divided into two groups: those with
AMI and COVID-19 (AMICOVID+) and those with AMI without COVID-19 (AMICOVID-). The primary outcome was
to evaluate the relationship between COVID-19 and MINOCA, expressed in relative frequencies and p-values calculated by
the Chi-squared test and corroborated by a sensitivity analysis using logistic regression.

Results: Of the 28 patients that met the inclusion criteria, 14 (50%) had AMICOVID+, and 14 (50%) had AMICOVID-.
MINOCA was significantly higher in the group with AMICOVID+ compared to AMICOVID- (85.7% vs. 21.4%. p =
0.001), showing no effect modification when sensitivity analysis was carried on. The raw data for statistical analyses was
also included in the appendices.

Conclusion: MINOCA was in a significantly higher proportion in the AMICOVID+ group than in the AMICOVID- group.
However, this study had a small sample size; therefore, these results must be corroborated in different populations
with larger sample sizes.