Cohort study
Clinical Characteristics and Prognosis of Myocardial Infarction with Nonobstructive Coronary Artery (MINOCA) Caused by Atherosclerotic and Nonatherosclerotic Mechanisms Assessed by Optical Coherence Tomography (OCT)
- Observational cohort study
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:10.1016/j.jcmg.2022.10.023
Summarised from the published abstract; every number is checked against it