Analysis of hereditary thrombophilia and antiphospholipid syndrome in patients with acute coronary syndrome based on registry data in the Krasnodar Territory

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Objective: to evaluate the prevalence of congenital and acquired thrombophilia in patients with myocardial infarction (MI). Materials and methods: thrombophilic factors were studied in patients included in the registry of acute coronary syndrome in the Krasnodar Territory. The sample included patients who were admitted for acute myocardial infarction at the Ochapovsky Regional Clinical Hospital, from November 2023 to November 2024, and who meet the universal diagnostic criteria for acute myocardial infarction. Based on the coronary angiography data, two groups were identified: 1 — patients with coronary artery stenosis 150%), lipoprotein (a) (> 30 mg/dl) and homocysteine (≥15 µm) were evaluated. Results: a comparison was conducted of 100 sequentially enrolled patients with myocardial infarction without obstructive (stenosis 50%) coronary arteries (MIOCA) (the average age is 50.8±12.9 years). The most significant incidence of hereditary thrombophilia was found in the group of patients with MINOCA (21 patients (21%) versus 9 (8.8%) with MIOKA (p=0.0076). In addition, hyperhomocysteinemia, APS, and elevated factor VIII were also more common among MINOCA patients. APS was detected in 13 (13.0%) patients with IBD, mainly in a single-positive form, and prevailed in patients with non-ST segment elevation myocardial infarction (11 patients (11.0%) versus 2 patients (2.0%) with ST segment elevation, p=0.0035). In turn, lipoprotein (a) was more common in patients with MIOKA (32 patients (31.4%) versus 18 patients (18.0%) with MIOKA, p=0.0221. Conclusions: the prevalence of thrombophilia, including APS, is higher in the group of patients without significant coronary artery damage. The study demonstrates that screening and detection of thrombophilia in patients with MINOCA is of high clinical importance. Based on the data obtained, it can be assumed that the appointment of long-term anticoagulant therapy will have a favorable prognosis in patients with IBD with certain disorders, especially with AFS.

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