Clinical Characteristics and Prognosis of Myocardial Infarction with Nonobstructive Coronary Artery (MINOCA) Caused by Atherosclerotic and Nonatherosclerotic Mechanisms Assessed by Optical Coherence Tomography (OCT)
An erratum to this article was published (JACC Cardiovasc Imaging, Jul 2023 ↗)
Authors' conclusion
OCT identified a cause in 61.1% of MINOCA, in which Ath-MINOCA represents an important and distinct MINOCA subset. Ath-MINOCA were more common and associated with worse outcomes.
Study context
- Population
- Patients with MINOCA assessed by OCT, among patients with MI who underwent angiographyof 294 MINOCA
- Participants
- 190 patients
- Exposure
- Atherosclerotic vs nonatherosclerotic MINOCA by OCT
- Atherosclerotic MINOCA (Ath-MINOCA)n = 99
- non-Ath-MINOCAn = 91reference
- Outcome
- MACE:
- Cardiac death
- Nonfatal MI
- Target lesion revascularization
- Stroke
- Rehospitalization for unstable
- Progressive angina
- Follow-up
- 1 year
Main finding
As reported in the abstract
MACE
P = 0.015
- Atherosclerotic cause independent predictor of major adverse cardiac events (MACE) (HR 5.36, 95% CI 1.08-26.55)
- P = 0.040
Observational data: associations, not effects.
Further findings
Composite of cardiac death and MI
- No difference
Causes of MINOCA by OCT
- Plaque erosion
- n = 64, 33.7%
- Plaque rupture
- n = 33, 17.4%
- Calcified nodule
- n = 2, 1.1%
- Spontaneous coronary artery dissection
- n = 8, 4.2%
- Coronary spasm
- n = 9, 4.7%
- Unclassified cause
- n = 74, 38.9%
- Cause identified by OCT
- 61.1%
Original publication
Clinical Characteristics and Prognosis of MINOCA Caused by Atherosclerotic and Nonatherosclerotic Mechanisms Assessed by OCT. JACC Cardiovasc Imaging. Published 14 December 2022. doi:10.
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