Coronary disease & ACSDiagnostic or prognostic study
Accuracy of Angiographic Identification of Culprit Lesions in Women With Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA)
- diagnostic accuracy study
- blinded independent review by two interventional cardiologists
- core laboratory confirmation with angiographic coregistration
Authors' conclusion
Interventional cardiologists could not reliably identify culprit arteries using coronary angiography in women with MINOCA, even after ECG and transthoracic echocardiography review. Our findings suggest that invasive angiography alone should not guide vessel selection for intracoronary imaging and support multivessel imaging when evaluating MINOCA.
Study context
- Population
- Women with MINOCA who had a coronary culprit lesion identified by multivessel optical coherence tomography (OCT)women with MINOCA
- Participants
- 64 women
- Comparison
- Interventional cardiologists' identification of the culprit artery on invasive coronary angiography, before and after review of ECG and transthoracic echocardiography, against OCT-defined culprit lesions
Performance
As reported in the abstract
left anterior descending
50.8%
right coronary
35.4%
Further findings
Identification of the culprit artery on angiography
- At least 1 interventional cardiologist identified the culprit artery
- 54.7% (95% CI, 42.6%-66.3%)
- Both identified it
- 28.1% (95% CI, 18.6%-40.1%)
Accuracy after addition of ECG and transthoracic echocardiography data
- Did not improve accuracy
- P = 0.40 and P =0.97
Identification in plaque rupture cases
- Culprit arteries identified by at least 1 cardiologist in plaque rupture cases
- 87.5%
Identification of circumflex lesions
- Circumflex lesions identified
- 11%
Baseline characteristics
- median age
- 64 years
- non-ST-segment elevation MI
- 97%
Original publication
Summarised from the published abstract; every number is checked against it