Classification and Outcomes of Coronary Microvascular Disease in Myocardial Infarction and Angina With Nonobstructive Coronary Arteries
Authors' conclusion
CMD is common in both MINOCA and ANOCA. The higher prevalence of endothelium-independent CMD in MINOCA suggests a potential mechanistic role in infarction. Patients with MINOCA have a worse prognosis than ANOCA, particularly when CMD is present.
Study context
- Population
- Patients with nonobstructive coronary arteries undergoing invasive coronary function testing from 2012 to 2022; myocardial infarction due to atherothrombosis, myocarditis, and Takotsubo syndrome excludedMINOCA 73 · ANOCA 549
- Participants
- 622 patients
- Exposure
- MINOCA compared with ANOCA
- MINOCAn = 73
- ANOCAn = 549reference
Methodological detailsinvasive coronary function testing, invasive provocation testing
- Invasive coronary function testing
- Invasive provocation testing
Main finding
As reported in the abstract
Coronary microvascular disease (CMD)
P = 0.271
Observational data: associations, not effects.
Further findings
Endothelium-independent CMD · more frequent in MINOCA
P < 0.001
Major adverse cardiovascular events · median follow-up of 4.5 years
adjusted hazard ratio 2.4 · P = 0.001
| Outcome | Hazard ratio (95% CI) | P value | |
|---|---|---|---|
| Major adverse cardiovascular events, CMD vs no CMD, within each group — CMD · MINOCA | 3.6 (1.1–12.0) | P = 0.038 | |
| Major adverse cardiovascular events, CMD vs no CMD, within each group — CMD · ANOCA | 7.9 (2.9–21.8) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Classification and Outcomes of Coronary Microvascular Disease in Myocardial Infarction and Angina With Nonobstructive Coronary Arteries. Circ Cardiovasc Interv. Published 15 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it