Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries

Vicente‐Ibarra, Nuria; Feliu, Eloísa; Bertomeu‐Martínez, Vicente; Cano-Vivar, Pedro; Carrillo-Sáez, Pilar; Morillas, Pedro; Nodar, Juan Miguel Ruíz

doi:10.1186/s12968-021-00773-w

Cited by 8 publications

(9 citation statements)

References 36 publications

(24 reference statements)

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“…A recent prospective multicenter registry found that late gadolinium enhancement involving 3 or more segments (versus a single segment with late gadolinium enhancement) was associated with triple the risk of major adverse cardiovascular events with CMR performed at a median of 12 days following admission. 38 In contrast, a retrospective study in which CMR was performed at a median of 37 days after presentation reported that cardiomyopathy was associated with worse prognosis (15% mortality at 3.5 years) compared with MI (4% mortality rate at 3.5 years). 39 …”

Section: Role Of Cardiovascular Magnetic Resonance Imaging In Minocamentioning

confidence: 93%

Role of Multimodality Imaging in the Assessment of Myocardial Infarction With Nonobstructive Coronary Arteries: Beyond Conventional Coronary Angiography

Gudenkauf

Hays

Tamis-Holland³

et al. 2022

JAHA

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Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous clinical entity, encompassing multiple different causes, and a cause of substantial morbidity and mortality. Current guidelines suggest a multimodality imaging approach in establishing the underlying cause for MINOCA, which is considered a working diagnosis. Recent studies have suggested that an initial workup consisting of cardiac magnetic resonance and invasive coronary imaging can yield the diagnosis in most patients. Cardiac magnetic resonance is particularly helpful in excluding nonischemic causes that can mimic MINOCA including myocarditis and Takotsubo cardiomyopathy, as well as for long‐term prognostication. Additionally, intracoronary imaging with intravascular ultrasound or optical coherence tomography may be warranted to evaluate plaque composition, or evaluate for plaque disruption or spontaneous coronary dissection. The role of noninvasive imaging modalities such as coronary computed tomography angiography is currently being investigated in the diagnostic approach and follow‐up of MINOCA and may be appropriate in lieu of invasive coronary angiography in select patients. In recent years, many strides have been made in the workup of MINOCA; however, significant knowledge gaps remain in the field, particularly in terms of treatment strategies. In this review, we summarize recent society guideline recommendations and consensus statements on the initial evaluation of MINOCA, review contemporary multimodality imaging approaches, and discuss treatment strategies including an ongoing clinical trial.

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Section: Role Of Cardiovascular Magnetic Resonance Imaging In Minocamentioning

confidence: 93%

Role of Multimodality Imaging in the Assessment of Myocardial Infarction With Nonobstructive Coronary Arteries: Beyond Conventional Coronary Angiography

Gudenkauf

Hays

Tamis-Holland³

et al. 2022

JAHA

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“…Similarly, dual antiplatelet therapy was not associated with the risk of MACEs (HR 0.86; 95% CI 0.63-1.18; P = 0.35, I 2 = 21%) among the four studies that enrolled subjects with myocardial infarction with nonobstructive coronary arteries (MINOCA) (Supplementary Fig. S2) [21,31,32,35].…”

Section: Primary Endpointmentioning

confidence: 96%

“…Thirteen published studies [19][20][21][22][23][28][29][30][31][32][33][34][35] with 34,463 patients were enrolled in our meta-analysis. The median follow-up duration was 36 months (range, 12-98 months).…”

Section: Study Selection and Baseline Characteristicsmentioning

confidence: 99%

“…The median follow-up duration was 36 months (range, 12-98 months). A history of baseline MI was reported in ve studies [21,[30][31][32]35], and a potential pathophysiological mechanism associated with CAS was published in four studies [22,23,29,30]. The prescription rate of aspirin in these studies ranged from 29.0-90.1% (Table 1).…”

Section: Study Selection and Baseline Characteristicsmentioning

confidence: 99%

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Association of Aspirin Therapy with Prognosis in Patients with Nonobstructive Coronary Artery Disease: A Systematic Review and Meta-Analysis

Fan

Mao

Zhou

et al. 2022

Preprint

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PurposeThe effect of aspirin therapy in patients with nonobstructive coronary artery disease (CAD) remains controversial. This study aimed to investigate the association between aspirin therapy and prognosis in nonobstructive CAD.MethodsWe searched for observational cohort studies on Pubmed, Embase, the Cochrane Library and Web of Science. Studies were included that compared the endpoint differences in patients with nonobstructive CAD who were treated with aspirin or not. The primary endpoint was a composite of major adverse cardiovascular events (MACEs). Secondary endpoints included all-cause death, cardiovascular death and myocardial infarction (MI). The pooled effect size was estimated as hazard ratio (HR) with 95% confidence interval (CI), which was measured by a random effect model using the generic inverse variance method.ResultsThirteen published studies with 34,463 patients were included. Pooled data showed that aspirin therapy was not associated with the risk of MACEs (HR 1.10; 95% CI 0.85–1.41; P = 0.47, I2 = 57%). Similar results were observed in cardiovascular death (HR 1.12; 95% CI 0.73–1.73; P = 0.60, I2 = 0%) and MI (HR 0.53; 95% CI 0.09–3.20; P = 0.49, I2 = 68%), except all-cause death (HR 0.77; 95% CI 0.63–0.95; P = 0.02, I2 = 25%). Subgroup analyses showed that there were no associations between aspirin therapy and MACEs in all subsets.ConclusionsRoutine aspirin therapy might not improve prognosis in patients with nonobstructive CAD. Aspirin therapy in non-obstructive CAD should be better investigated and future research is needed. A personalized antiplatelet regimen might contribute to reduction in ischemic cardiovascular events in patients with non-obstructive CAD.Registration: PROSPERO (CRD42021281706).

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“…1). Thirteen published studies [11][12][13][14][15][20][21][22][23][24][25][26][27] with 34,463 patients were enrolled in our meta-analysis. The median follow-up duration was 36 months (range, 12-98 months).…”

Section: Study Selection and Baseline Characteristicsmentioning

confidence: 99%

Association of aspirin therapy with prognosis in patients with non obstructive coronary artery disease: A systematic review and meta-analysis

Jin¹

2022

J Clin Images Med Case Rep

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Background: The effect of aspirin therapy in patients with nonobstructive Coronary Artery Disease (CAD) remains controversial. This study aimed to investigate the association between aspirin therapy and prognosis in nonobstructive CAD. Methods: We searched for observational cohort studies on Pubmed, Embase, the Cochrane Library and Web of Science. Studies were included that compared the endpoint differences in patients with nonobstructive CAD who were treated with aspirin or not. The primary endpoint was a composite of Major Adverse Cardiovascular Events (MACEs). Secondary endpoints included all-cause death, cardiovascular death and Myocardial Infarction (MI). The pooled effect size was estimated as Hazard Ratio (HR) with 95% Confidence Interval (CI), which was measured by a random effect model using the generic inverse variance method. Results: Thirteen published studies with 34,463 patients were included Pooled data showed that aspirin therapy was not associated with the risk of MACEs (HR 1.10; 95% CI 0.85–1.41; P=0.47, I2=57%). Similar results were observed in cardiovascular death (HR 1.12; 95% CI 0.73–1.73; P=0.60, I2=0%) and MI (HR 0.53; 95% CI 0.09–3.20; P=0.49, I2=68%), except all-cause death (HR 0.77; 95% CI 0.63–0.95; P=0.02, I2=25%). Subgroup analyses showed that there were no associations between aspirin therapy and MACEs in all subsets. Conclusions: Routine aspirin therapy might not be associated with a decreased risk of cardiovascular events in patients with nonobstructive CAD. Aspirin therapy in non-obstructive CAD should be better investigated and future research is needed. A personalized antiplatelet regimen may contribute to reduction in ischemic cardiovascular events for these patients.

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Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries

Cited by 8 publications

References 36 publications

Role of Multimodality Imaging in the Assessment of Myocardial Infarction With Nonobstructive Coronary Arteries: Beyond Conventional Coronary Angiography

Role of Multimodality Imaging in the Assessment of Myocardial Infarction With Nonobstructive Coronary Arteries: Beyond Conventional Coronary Angiography

Association of Aspirin Therapy with Prognosis in Patients with Nonobstructive Coronary Artery Disease: A Systematic Review and Meta-Analysis

Association of aspirin therapy with prognosis in patients with non obstructive coronary artery disease: A systematic review and meta-analysis

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