Coronary disease & ACSCohort study
Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population
- Retrospective cohort study
- multicentre
- observational
- registry-based (NCDR CathPCI linked to CMS claims)
Authors' conclusion
This study confirms an unfavourable prognosis in elderly patients with MINOCA undergoing coronary angiography, with one in five patients with MINOCA suffering a major adverse event over 12 months.
Study context
- Population
- Patients ≥65 years with acute myocardial infarction (AMI) undergoing coronary angiography, NCDR CathPCI Registry linked to Medicare claims, July 2009–December 2013
- Participants
- 286,780 AMI admissions
- Exposure
- MINOCA vs MICAD
- MINOCAn = 16,849
- Outcome
- MACE:
- All-cause mortality
- Re-hospitalization for AMI
- HF
- Stroke
- Follow-up
- 12 months
Main finding
MACE
Hazard ratio
0.57
95% CI 0.55–0.59
By group
MINOCA vs MICAD
HR 0.57 (95% CI 0.55–0.59)
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
All-cause mortality · 12 months
Re-hospitalization for AMI · 12 months
Re-hospitalization for HF · 12 months
Re-hospitalization for stroke · 12 months
- All-cause mortality: P < 0.001
- Re-hospitalization for AMI: P < 0.001
- Re-hospitalization for heart failure (HF): P < 0.001
- Re-hospitalization for stroke: P = 0.128
Adjusted risks of major adverse cardiac events (MACE) components · 12 months
- Pattern similar to MACE
Original publication
Myocardial infarction with non-obstructive coronary arteries as compared with myocardial infarction and obstructive coronary disease: outcomes in a Medicare population. Eur Heart J. Published 21 June 2019. doi:10.1093/eurheartj/ehz403
Summarised from the published abstract; every number is checked against it