What question did this study set out to answer?

The aim is to examine sex differences in Portuguese patients diagnosed with MINOCA and their clinical outcomes.

February 8, 2026European Heart Journal

Sex-related differences in suspected MINOCA: a multicentre national registry analysis

Q: What does this research mean for the field?

Women with suspected MINOCA had a higher incidence of in-hospital major adverse cardiac events (10%), yet sex was not an independent predictor after adjustment. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

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Key result

Female sex does not independently drive higher in-hospital MACE in suspected MINOCA after clinical adjustment.

Why the study?

Sex differences in myocardial infarction with nonobstructive coronary arteries (MINOCA) are not fully understood.

Does female sex increase the risk of in-hospital MACE in patients with suspected MINOCA?

Key Points

The aim is to examine sex differences in Portuguese patients diagnosed with MINOCA and their clinical outcomes.
Retrospective multicentre study of MINOCA patients from a national registry (2010-2022)
Comparison of baseline characteristics and in-hospital major adverse cardiac events (MACE) by sex
Multivariate analysis to identify predictors of in-hospital MACE
Out of 33686 registry patients, 3668 had suspected MINOCA (15%)
Women represented 35% of MINOCA cases and had a higher prevalence of multiple comorbidities
The composite of in-hospital MACE was higher in women but sex was not an independent predictor after adjustment

Structured PICO

Does female sex increase the risk of in-hospital MACE in patients with suspected MINOCA?

Population

3,668 Portuguese patients with clinically suspected MINOCA (15% of AMI) from the Portuguese Registry on Acute Coronary Syndromes (2010-2022), mean age 66 ± 13 years, 35% female.

Intervention

Female sex

Comparator

Male sex

Outcome

Composite of in-hospital major adverse cardiac events (MACE - death, stroke or AMI)composite

In patients with suspected MINOCA, women have a higher unadjusted rate of in-hospital MACE, but sex is not an independent predictor of adverse outcomes after adjusting for confounders.

Discussion

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Implication

Sex not independently linked to MINOCA MACE after adjustment; leaves open residual confounding in observational cohorts.

Cite This Study

Goncalves et al. (2025) studied this question. Women with suspected MINOCA had higher in-hospital MACE rates, but sex was not an independent predictor after adjusting for age and clinical factors.

synapsesocial.com/papers/698827670fc35cd7a8846285 https://doi.org/10.1093/eurheartj/ehaf784.2175

Topics

Coronary artery disease

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Sex-related differences in suspected MINOCA: a multicentre national registry analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Sex-related differences in suspected MINOCA: a multicentre national registry analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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