Prognostic Value of Cardiac Magnetic Resonance Imaging in Patients With a Working Diagnosis of MINOCA—An Outcome Study With up to 10 Years of Follow-Up
Authors' conclusion
In patients with a working diagnosis of MINOCA, CMR allows ruling-out true MINOCA in over half of the patients. CMR diagnoses of AMI, myocarditis, and NICM are associated with worse MACE-free survival, whereas a normal CMR study portends a benign prognosis.
Study context
- Population
- Consecutive patients with a working diagnosis of MINOCA clinically referred for cardiac magnetic resonance (CMR), academic hospital, October 2003–February 2020
- Participants
- 252 patients
- Exposure
- CMR diagnosis categories vs normal CMR
- Acute myocardial infarction (AMI)n = 63
- Myocarditisn = 33
- Nonischemic cardiomyopathy (NICM)n = 111
- Normal CMRn = 37reference
- Other diagnosesn = 8
- Outcome
- MACE
- Follow-up
- Up to 10 years
Methodological detailsconsecutive patients, single academic hospital
- Consecutive patients
- Single academic hospital
Main finding
As reported in the abstract
Unadjusted cumulative 10-year MACE rate
- Difference across CMR diagnoses (log-rank)
- P < 0.001
- Incremental prognostic value of CMR diagnosis over clinical factors (incremental χ²)
- 17.9, P<0.001
Observational data: associations, not effects.
Further findings
True MINOCA ruled out by specific nonischemic cause
- Proportion of cohort
- 57%
Overall MACE and deaths during follow-up (1595 patient-years) · up to 10 years
- MACE
- 84 patients (33%)
- Deaths
- 64 (25%)
Original publication
Prognostic Value of Cardiac Magnetic Resonance Imaging in Patients With a Working Diagnosis of MINOCA—An Outcome Study With up to 10 Years of Follow-Up. Circ Cardiovasc Imaging. Published 15 August 2023. doi:10.
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