Coronary disease & ACS

Stratified medicine with eplerenone for myocardial infarction or injury and no obstructive coronary arteries: A registry-based basket trial

Am Heart JPublished prospective, registry-based, multicenter, diagnostic study and nested, randomized, controlled, open-label, blinded-endpoint (PROBE) basket trial

Study context

Population
Patients with clinically suspected Myocardial Infarction with No Obstructive Coronary Arteries (MINOCA) and one or more cardiovascular risk factors; patients with an index of coronary microvascular resistance (IMR) ≥ 25 randomizedplanned enrolment into the registry-based diagnostic study, n = 150 randomized · randomized (IMR ≥ 25) 150
Participants
Up to 400 patients
Planned comparison
Eplerenone or standard care without eplerenone
Primary endpoint
Within-individual change in NT-proBNP (primary outcome of the randomized trial), intention-to-treat
Follow-up
Baseline, 1 month, and 6 months
Methodological detailsendotypes centrally adjudicated by a panel of blinded cardiologists, intention-to-treat
  • Endotypes centrally adjudicated by a panel of blinded cardiologists
  • Intention-to-treat

No results yet. This paper sets out the design of a trial; its results are to come.

Further findings

Proportion of patients with IMR ≥ 25 during index coronary angiography (primary outcome of the diagnostic study)

Protocol; no results reported

Original publication

Stratified medicine with eplerenone for myocardial infarction or injury and no obstructive coronary arteries: A registry-based basket trial. Am Heart J. Published 2 July 2026. doi:10.1016/j.ahj.2026.107518

Summarised from the published abstract; every number is checked against it

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