Key result
Female sex is linked to ~3-fold higher odds of MINOCA in young adults with AMI.
Why the study?
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous clinical entity in young adults requiring accurate differentiation from obstructive myocardial infarction for appropriate diagnosis and management.
What is the frequency and clinical profile of MINOCA compared to obstructive myocardial infarction in young adults presenting with acute MI?
Cross-Sectional (n=290)
What is the frequency and clinical profile of MINOCA compared to obstructive myocardial infarction in young adults presenting with acute MI?
In young adults presenting with acute MI, MINOCA accounts for nearly 15% of cases and is significantly more common in women, highlighting the need for mechanism-oriented evaluation.
Answers are grounded in this paper and cite their sources.
MINOCA merits consideration in young adults with MI, especially women; cross-sectional data leave mechanisms and management open for prospective study.
Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous clinical entity that is particularly relevant in younger adults and women. Accurate differentiation from obstructive myocardial infarction and identification of the underlying mechanism are important because clinical presentation, diagnostic pathways, and management may differ substantially. Objective: To characterize the frequency, etiological distribution, clinical profile, treatment patterns, and short-term outcomes of working MINOCA compared with obstructive myocardial infarction among young adults aged 18–45 years. Methods: An analytical cross-sectional framework was applied to a dataset of 290 acute myocardial infarction observations classified according to coronary angiographic findings. Working MINOCA was defined by the absence of ≥50% stenosis in any major epicardial coronary artery. Demographic, cardiovascular, psychosocial, clinical, treatment, and in-hospital outcome variables were compared between groups. Binary logistic regression was used to examine factors associated with working MINOCA classification. Results: Working MINOCA accounted for 43 of 290 observations (14.8%). Female sex was more frequent in the MINOCA group than in the obstructive myocardial infarction group (44.2% vs. 21.5%, p=0.001). MINOCA was also characterized by lower body mass index, less current smoking, less frequent ST-segment elevation, lower peak troponin I, and higher perceived-stress scores. Plaque disruption and coronary vasospasm were the most frequent assigned mechanisms. Female sex was associated with working MINOCA classification in multivariable analysis (adjusted OR 2.94; 95% CI 1.46–5.92; p=0.003). Conclusion: Working MINOCA represented a clinically distinct subgroup within the analytical dataset. Mechanism-oriented classification and broader clinical profiling may improve the structured evaluation of young adults presenting with myocardial infarction and non-obstructive coronary arteries
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Rizvi et al. (2026) conducted a cross-sectional in Acute Myocardial Infarction (n=290). Female sex vs. Male sex was evaluated on Working MINOCA classification (adjusted OR 2.94, 95% CI 1.46-5.92, p=0.003). Among young adults with acute myocardial infarction, female sex was associated with a working MINOCA classification.
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