Comparative Analysis of Minoca Phenotypes in Central Africa: Distinguishing Stemi and Nstemi Presentations

Background: Data on Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) in sub-Saharan Africa is limited and not existing in Central Africa. We sought to characterize the clinical and angiographic profiles of MINOCA patients in Yaoundé, Cameroon, comparing them to those with obstructive myocardial infarction (MI). Methods: We conducted a cross-sectional study of patients admitted to the cardiac catheterization laboratory in Yaoundé. MINOCA was defined according to ESC criteria. Comparisons were made between MINOCA and obstructive MI groups. Results: Out of 69 patients with MI, 11 (15.9%) met the criteria for MINOCA. Patients with MINOCA were significantly younger than those with obstructive MI (47.55 ± 13, 67 years vs. 58.76 ± 10.49 years; p = 0.003), with 27.3% aged ≤ 40 years. Hypertension was less frequently observed in the MINOCA group (36.4% vs. 75.9%; p = 0.027), as was a history of ischemic heart disease (9.1% vs. 44.8%; p = 0.041). Notably, STEMI was the most frequent clinical presentation in MINOCA patients (72.7%), mirroring the proportion seen in obstructive MI (74.1%). MINOCA patients also had more preserved cardiac function, with a lower prevalence of impaired LVEF < 50% (18.2% vs. 53.4%; p = 0.032). Conclusion: In this first comparative analysis in Cameroon, MINOCA represents nearly 1 in 6 MI cases and appeared to affects younger patients in our series. The high prevalence of STEMI-MINOCA (72.7%) highlights that ST-elevation in the absence of obstructive disease is a common and critical phenotype in this population.