Systematic Review of Patients Presenting With Suspected Myocardial Infarction and Nonobstructive Coronary Arteries
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Key result
MINOCA carries ~30% lower 12-month mortality compared to MI-CAD.
Population
176,502 consecutive myocardial infarction patients who had coronary angiography performed, including pooled…
Design
Meta-analysis
Follow-up
12 months
Authors
Discussion
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Implication
Clinicians should include MINOCA in MI differentials given its frequency and mortality; meta-analysis extends prior estimates with systematic pooling across large cohorts.
Structured PICO
P
Population
176,502 consecutive myocardial infarction (MI) patients who had coronary angiography performed (for prevalence analysis), including pooled MINOCA patients for clinical features (n=11,334 for gender, n=9,986 for age).
C
Comparator
Myocardial infarction associated with obstructive coronary artery disease (MI-CAD)
O
Outcome
Prevalence, clinical features, and 12-month all-cause mortalityhard clinical
MINOCA accounts for approximately 6% of MI presentations and is associated with a lower but still guarded 12-month all-cause mortality (4.7%) compared to MI with obstructive CAD.
Limitations
- Considerably heterogeneous follow-up periods in prognostic studies
- Few studies reported the prevalence of cardiac mortality or reinfarction
- Significant heterogeneity among studies (e.g., I2 statistic 99% for prevalence)
Cite This Study
Pasupathy et al. (2015) studied this question. The prevalence of MINOCA was 6% with 12-month all-cause mortality at 4.7%, lower than the 6.7% for myocardial infarction with obstructive coronary artery disease.
Topics
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