The DiagnOsis of myocardial infarction with non-obstructive coronary arteries (MINOCA) (DOMINO) registry: a real-world use of multimodality imaging and its impact on etiologic classification
Authors' conclusion
Advanced diagnostic testing was associated with a higher likelihood of a determined etiologic diagnosis in MINOCA, despite marked international variability in its use; however, this association is partly definitional, as advanced testing directly contributes to diagnostic ascertainment for several etiologic categories.
Study context
- Population
- Patients with MINOCA in an international registry
- Participants
- 365 patients · 17 centres · 13 countries
- Exposure
- Advanced diagnostic testing vs no advanced testing
- Outcome
- Diagnostic resolution (specific etiologic diagnosis)
Methodological detailsmulticentre, non-commercial, 17 centres in 13 countries
- Multicentre
- Non-commercial
- 17 centres in 13 countries
Main finding
As reported in the abstract
Advanced testing vs No advanced testingOdds ratio (95% CI)P value
Standard model
3.94(1.59–10.06)
Cluster-robust model
3.75(0.95–14.72)
P = 0.058GEE model
3.69(1.04–13.11)
- Specific etiologic diagnosis reached
- 337/365 (92.3%)
- Guideline-directed testing performed
- 254/365 (69.6%)
Observational data: associations, not effects.
Further findings
| Outcome | Advanced testing | No advanced testing | |
|---|---|---|---|
| Diagnostic resolution by extent of testing | Not reported in the abstract | 85.6% | Advanced testing: not reported in the abstract |
- Diagnostic resolution by extent of testing — Trend across extent of testing
- trend P = 0.02
- Diagnostic resolution by extent of testing: Cardiac magnetic resonance (CMR) plus invasive/functional assessment 97.1%
Guideline-directed testing by country
- Varied markedly by country (0-100%)
- P < 0.0001
Discharge pharmacotherapy by etiologic diagnosis
- Varied significantly by etiologic diagnosis
- P = 0.0001
Original publication
The DiagnOsis of MINOCA (DOMINO) registry: a real-world use of multimodality imaging and its impact on etiologic classification. Eur J Prev Cardiol. Published 28 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it