In patients with MINOCA, female sex was not associated with a significantly different risk of long-term all-cause mortality compared with male sex (OR 1.03; 95% CI 0.87-1.22).
Meta-Analysis (n=30,281)
Does female sex affect the risk of adverse outcomes in patients with MINOCA compared to male sex?
In patients with MINOCA, long-term outcomes are similar between sexes despite differing baseline comorbidities, although women face a higher risk of in-hospital MACE.
Odds Ratio: 1.03 (95% CI 0.87–1.22)
BACKGROUND: Although myocardial infarction with nonobstructive coronary arteries (MINOCA) is more common in women, it is unknown whether sex is a risk factor for adverse outcomes in patients with MINOCA. We aimed to investigate the relationship between sex differences and outcomes of patients with MINOCA. METHODS AND RESULTS: A systematic literature search was performed in PubMed, Embase, and Cochrane databases from their inception until August 2023 for relevant studies. End points were pooled using the Hartung-Knapp-Sidik-Jonkman random-effects model as odds ratio (OR) with 95% CIs. Nine studies, involving 30 281 patients with MINOCA (comprising 18 079 women and 12 202 men), were included in the study. Women were older and had a higher prevalence of hypertension, diabetes, and stroke compared with men. The median duration of follow-up was 3.5 years, with an interquartile range of 2.2 to 4.2 years. Pooled analysis revealed no statistically significant difference in the risk of all-cause mortality (OR, 1.03 95% CI, 0.87-1.22), major adverse cardiovascular events (OR, 1.18 95% CI, 0.89-1.58), heart failure (OR, 1.32 95% CI, 0.57-3.03), stroke (OR, 1.13 95% CI, 0.56-2.26), and myocardial infarction (OR, 1.04 95% CI, 0.29-3.76) between the 2 groups. Regarding short-term outcomes, women had a significantly higher risk of in-hospital major adverse cardiovascular events compared with men (OR, 1.33 95% CI, 1.16-1.53) whereas there was no significant difference in the risk of in-hospital mortality (OR, 0.90 95% CI, 0.64-1.28) between the 2 patient groups. CONCLUSIONS: Despite the differences in demographics and comorbidity profiles, there was no significant difference in the long-term outcomes for patients with MINOCA between sexes. However, it is noteworthy that women experienced a higher risk of in-hospital major adverse cardiovascular events compared with men.
Ang et al. (Wed,) conducted a meta-analysis in Myocardial infarction with nonobstructive coronary arteries (MINOCA) (n=30,281). Female sex vs. Male sex was evaluated on All-cause mortality (OR 1.03, 95% CI 0.87-1.22). In patients with MINOCA, female sex was not associated with a significantly different risk of long-term all-cause mortality compared with male sex (OR 1.03; 95% CI 0.87-1.22).