{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:40:53Z","timestamp":1760146853018,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Troponin level elevation without an obstructive culprit lesion is caused by heterogenous entities. The effect of aging on this condition has been poorly investigated. Methods: After screening 24,775 patients between 2010 and 2021, this study included a total of 373 patients with elevated troponin levels without an obstructive culprit lesion or suspected myocardial infarction with non-obstructive coronary arteries (MINOCAs) categorized into four age groups containing 78 patients (&lt;51 years), 72 patients (51\u201360 years), 81 patients (61\u201370 years), and 142 patients (&gt;70 years). This study analyzed the baseline characteristics, the in-hospital complications, in-hospital mortality, and the long-term outcomes. Results: The older patients exhibited a higher rate of major adverse cardiovascular in-hospital events than those of the other age groups (15.4% in the &lt;51-year-old group vs. 36.1% in the 51\u201360-year-old group vs. 33.3% in the 61\u201370-year-old group vs. 47.2% in the &gt;70-year-old group; p &lt; 0.001). However, the rate of non-sustained ventricular tachycardia (nsVT) was higher in the 51\u201360-year-old patients than those of the other age groups (5.6% in the 51\u201360-year-old group vs. 1.3% in the 61\u201370-year-old group vs. 0.7% in the &gt;70-year-old group; p = 0.027). At the 11-year follow-up, cardiovascular mortality was higher among the older patients compared to that of the younger patients (3.9% in the 61\u201370-year-old group vs. 4.2% in the &gt;70-year-old group, p = 0.042), while non-cardiovascular mortality was comparable between the age groups. Conclusions: The older patients with troponin level elevation without an obstructive culprit lesion experienced a higher incidence of major adverse cardiovascular events during hospitalization compared to that of the younger groups. Additionally, higher cardiovascular mortality rates were revealed in the older patients at a long-term follow-up.<\/jats:p>","DOI":"10.3390\/jcm13247685","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T03:46:02Z","timestamp":1734407162000},"page":"7685","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Age Variation in Patients with Troponin Level Elevation Without Obstructive Culprit Lesion or Suspected Myocardial Infarction with Non-Obstructive Coronary Arteries\u2014Long-Term Data Covering over Decade"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4766-5523","authenticated-orcid":false,"given":"Mohammad","family":"Abumayyaleh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"},{"name":"European Center for AngioScience (ECAS) and DZHK (German Center for Cardiovascular Research (DZHK)), Partner Site, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clara","family":"Schlettert","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr-University Bochum, 44789 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6898-4871","authenticated-orcid":false,"given":"Daniel","family":"Materzok","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr-University Bochum, 44789 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"M\u00fcgge","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr-University Bochum, 44789 Bochum, Germany"},{"name":"Institut f\u00fcr Forschung und Lehre (IFL), Department of Molecular and Experimental Cardiology, Ruhr-University Bochum, 44791 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3053-0008","authenticated-orcid":false,"given":"Nazha","family":"Hamdani","sequence":"additional","affiliation":[{"name":"Institute of Physiology, Department of Cellular and Translational Physiology, Ruhr-University Bochum, 44801 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Akin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assem","family":"Aweimer","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr-University Bochum, 44789 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"El-Battrawy","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Forschung und Lehre (IFL), Department of Molecular and Experimental Cardiology, Ruhr-University Bochum, 44791 Bochum, Germany"},{"name":"Institute of Physiology, Department of Cellular and Translational Physiology, Ruhr-University Bochum, 44801 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,17]]},"reference":[{"key":"ref_1","first-page":"e891","article-title":"Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association","volume":"139","author":"Jneid","year":"2019","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/2048872618782414","article-title":"Editor\u2019s Choice- Pathophysiology, diagnosis and management of MINOCA: An update","volume":"8","author":"Scalone","year":"2019","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e013361","DOI":"10.1161\/JAHA.119.013361","article-title":"Myocardial Infarction With Nonobstructive Coronary Arteries: A Call for Individualized Treatment","volume":"8","author":"Mukherjee","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e011990","DOI":"10.1161\/JAHA.119.011990","article-title":"Prognosis and Predictors of Mortality in Patients Suffering Myocardial Infarction With Non-Obstructive Coronary Arteries","volume":"8","author":"Choo","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1161\/CIRCULATIONAHA.116.026336","article-title":"Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease","volume":"135","author":"Lindahl","year":"2017","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1161\/CIRCINTERVENTIONS.113.000606","article-title":"Prognosis of patients with non-ST-segment-elevation myocardial infarction and nonobstructive coronary artery disease: Propensity-matched analysis from the Acute Catheterization and Urgent Intervention Triage Strategy trial","volume":"7","author":"Planer","year":"2014","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ejim.2023.08.011","article-title":"Predictive value of Killip classification in MINOCA patients","volume":"117","author":"Armillotta","year":"2023","journal-title":"Eur. J. Intern. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.2217\/fca-2020-0213","article-title":"Comparison of the prognosis and outcome of heart failure with reduced ejection fraction patients treated with sacubitril\/valsartan according to age","volume":"17","author":"Abumayyaleh","year":"2021","journal-title":"Future Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC Guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_10","first-page":"143","article-title":"ESC working group position paper on myocardial infarction with non-obstructive coronary arteries","volume":"38","author":"Agewall","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/eurheartj\/ehy462","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"40","author":"Thygesen","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1373\/clinchem.2019.307405","article-title":"Diagnostic Evaluation of a High-Sensitivity Troponin I Point-of-Care Assay","volume":"65","author":"Sorensen","year":"2019","journal-title":"Clin. Chem."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ahj.2016.07.013","article-title":"Safety and efficacy of the 0 h\/3 h protocol for rapid rule out of myocardial infarction","volume":"181","author":"Wildi","year":"2016","journal-title":"Am. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1093\/eurheartj\/ehaa575","article-title":"2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation","volume":"42","author":"Collet","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1023\/A:1013797722156","article-title":"Age-associated cardiovascular changes in health: Impact on cardiovascular disease in older persons","volume":"7","author":"Lakatta","year":"2002","journal-title":"Heart Fail. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Gabaldon-Perez, A., Bonanad, C., Garcia-Blas, S., Marcos-Garces, V., D\u2019Gregorio, J.G., Fernandez-Cisnal, A., Valero, E., Minana, G., Merenciano-Gonzalez, H., and Mollar, A. (2023). Clinical Predictors and Prognosis of Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) without ST-Segment Elevation in Older Adults. J. Clin. Med., 12.","DOI":"10.3390\/jcm12031181"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1161\/CIRCULATIONAHA.114.011201","article-title":"Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries","volume":"131","author":"Pasupathy","year":"2015","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1093\/ehjacc\/zuad059","article-title":"Sex- and age-related differences in outcomes of patients with acute myocardial infarction: MINOCA vs. MIOCA","volume":"12","author":"Canton","year":"2023","journal-title":"Eur. Heart J. Acute Cardiovasc. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e009174","DOI":"10.1161\/JAHA.118.009174","article-title":"Presentation, Clinical Profile, and Prognosis of Young Patients With Myocardial Infarction With Nonobstructive Coronary Arteries (MINOCA): Results From the VIRGO Study","volume":"7","author":"Safdar","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5603\/CJ.a2017.0139","article-title":"Psycho-emotional disorders as incoming risk factors for myocardial infarction with non-obstructive coronary arteries","volume":"25","author":"Pais","year":"2018","journal-title":"Cardiol. J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Lopez-Pais, J., Izquierdo Coronel, B., Raposeiras-Roubin, S., Alvarez Rodriguez, L., Vedia, O., Almendro-Delia, M., Sionis, A., Martin-Garcia, A.C., Uribarri, A., and Blanco, E. (2022). Differences Between Takotsubo and the Working Diagnosis of Myocardial Infarction With Nonobstructive Coronary Arteries. Front. Cardiovasc. Med., 9.","DOI":"10.3389\/fcvm.2022.742010"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1002\/clc.23386","article-title":"Association between anxiety and clinical outcomes in Chinese patients with myocardial infarction in the absence of obstructive coronary artery disease","volume":"43","author":"He","year":"2020","journal-title":"Clin. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1016\/j.jacc.2020.02.057","article-title":"Age-Related Variations in Takotsubo Syndrome","volume":"75","author":"Cammann","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.atherosclerosis.2015.04.816","article-title":"Myocarditis or \u201ctrue\u201d infarction by cardiac magnetic resonance in patients with a clinical diagnosis of myocardial infarction without obstructive coronary disease: A meta-analysis of individual patient data","volume":"241","author":"Tornvall","year":"2015","journal-title":"Atherosclerosis"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e004185","DOI":"10.1161\/JAHA.116.004185","article-title":"Nonobstructive Versus Obstructive Coronary Artery Disease in Acute Coronary Syndrome: A Meta-Analysis","volume":"5","author":"Pizzi","year":"2016","journal-title":"J. Am. Heart Assoc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11897-023-00605-1","article-title":"MINOCA and INOCA: Role in Heart Failure","volume":"20","author":"Almeida","year":"2023","journal-title":"Curr. Heart Fail. Rep."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ijcard.2019.02.036","article-title":"Myocardial infarction with non-obstructive coronary arteries (MINOCA) in Chinese patients: Clinical features, treatment and 1 year follow-up","volume":"287","author":"Abdu","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ijcard.2019.09.037","article-title":"Characteristics and in-hospital mortality of patients with myocardial infarction in the absence of obstructive coronary artery disease in super-aging society","volume":"301","author":"Ishii","year":"2020","journal-title":"Int. J. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Quesada, O., Yildiz, M., Henry, T.D., Okeson, B.K., Chambers, J., Shah, A., Stanberry, L., Volpenhein, L., Aziz, D., and Lantz, R. (2023). Characteristics and Long-term Mortality in Patients with ST-Segment Elevation Myocardial Infarction with Non-Obstructive Coronary Arteries (STE-MINOCA): A High Risk Cohort. medRxiv.","DOI":"10.1101\/2023.02.05.23285502"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.amjmed.2019.05.048","article-title":"Predictors of Mortality in Myocardial Infarction and Nonobstructed Coronary Arteries: A Systematic Review and Meta-Regression","volume":"133","author":"Pelliccia","year":"2020","journal-title":"Am. J. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7685\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:53:33Z","timestamp":1760115213000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7685"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,17]]},"references-count":30,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13247685"],"URL":"https:\/\/doi.org\/10.3390\/jcm13247685","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2024,12,17]]}}}