الفهرس 
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Abstract
Myocardial infarction with nonobstructive coronary arteries (MINOCA) is clinically defined by the presence of the universal acute myocardial infarction (AMI) criteria, absence of obstructive coronary artery disease (≥50% stenosis), and no overt cause for the clinical presentation at the time of angiography.
The estimated prevalence of MINOCA is approximately (6-8)% among patients presenting with acute MI and is more common in women than in men. Using only routine investigations such as electrocardiography (ECG), troponin concentration, and invasive coronary angiography, clinicians are often left wondering about the true cause of this clinical syndrome in any given patient so diagnosis may require multiple diagnostic tools, including cardiac imaging or provocative tests, in addition to standard coronary angiography, according to clinical suspicion.The aim of the work was to assess the prevalence and clinical characteristics of Egyptian patients with myocardial infarction with non-obstructive coronary arteries. This prospective and observational study was conducted at Tanta university hospital and El Zeitoun specialized hospital on 844 patients, divided into MINOCA group (n=68) and Obstructive coronary artery disease group (n=776). The mean age of patients in the MINOCA group is significantly lower at 47.57 years compared to 53.05 years in the obstructive coronary artery disease group (p-value < 0.001). In terms of gender distribution, a higher percentage of males is observed in both groups, but the difference is statistically significant (58.82% in the MINOCA group vs. 71.26% in the obstructive coronary artery disease group, p-value = 0.031). DM, hypertension, smoking and dyslipidemia were significantly higher in obstructive coronary artery disease group than MINOCA group (P value <0.05). Family history and PVD were insignificantly different between both groups. Creatinine was insignificantly different between both groups. CKMB was significantly higher in obstructive coronary artery disease group than MINOCA group (P value<0.001). Killip’s classification was significantly different between both groups. In MINOCA group, Coronary artery was normal in 36 (52.94%) patients, ectasia in 9 (13.24%) patients, dissection in 8 (11.59%) patients, bridge in 3 (4.41%) patients and slow flow in 12 (17.65%) patients. In Obstructive coronary artery disease group, Coronary artery obstruction occurred in LAD in 369 (47.55%) patients, LCx in 116 (14.95%), RCA in 237 (30.54%) patients, OM in 36 (4.64%) patients and LM in 18 (2.32%) patients. EF was significantly lower in obstructive coronary artery disease group than MINOCA group (P value<0.001). As regard complications, Shock, life threatening ventricular arrythmia, A Fib, CIN, inotropes, DC and HD were insignificantly different between both groups. CHB, temporary pacing and LV thrombus were significantly higher in obstructive coronary artery disease group than MINOCA group (P value=0.011, 0.023 and 0.029 respectively) .mortality was insignificantly different between both groups.