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July 27, 2019European Heart Journal

Myocardial infarction with non-obstructive coronary arteries: dealing with pears and apples

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Key result

MINOCA was associated with significantly lower 12-month rates of MACEs (18.7% vs. 27.6%) and mortality (12.3% vs. 16.7%) compared to MICAD in patients over 65 years old.

Design

Editorial

Authors

FCFilippo CreaRMRocco Antonio MontoneGNGiampaolo Niccoli

Discussion

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Overview

Supports differential prognosis by CAD extent in elderly MI; extends meta-analytic data but leaves open therapeutic implications.

PICO

P
Population
286,780 patients aged >65 years admitted with acute myocardial infarction, followed for 12 months.
E
Exposure / Comparator
Myocardial infarction with non-obstructive coronary arteries (MINOCA) vs Myocardial infarction and obstructive coronary artery disease (MICAD)
O
Primary Outcome
Major adverse cardiac events (MACEs)

Main Result

Absolute Event Rate: 18.7% vs 27.6%

Limitations

  • Does not provide any insight into the prognosis across the different causes of MINOCA.

Cite This Study

Crea et al. (2019) conducted an editorial in Acute myocardial infarction (AMI) (n=286,780). Myocardial infarction with non-obstructive coronary arteries (MINOCA) vs. Myocardial infarction and obstructive coronary artery disease (MICAD) was evaluated on Major adverse cardiac events (MACEs). MINOCA was associated with significantly lower 12-month rates of MACEs (18.7% vs. 27.6%) and mortality (12.3% vs. 16.7%) compared to MICAD in patients over 65 years old.

synapsesocial.com/papers/6a7da42e8b7e38892f150474https://doi.org/10.1093/eurheartj/ehz561
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Systematic Review of Patients Presenting With Suspected Myocardial Infarction and Nonobstructive Coronary Arteries2015 · 1,001 citations
  2. 2Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease2017 · 485 citations
  3. 3The What, When, Who, Why, How and Where of Myocardial Infarction With Non-Obstructive Coronary Arteries (MINOCA)2015 · 82 citations
  4. 4Patients with acute myocardial infarction and non-obstructive coronary arteries: safety and prognostic relevance of invasive coronary provocative tests2017 · 324 citations
  5. 5Prognosis of Patients With Non–ST-Segment–Elevation Myocardial Infarction and Nonobstructive Coronary Artery Disease2014 · 193 citations