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

BACKGROUND: It is estimated that 5% to 10% of patients with myocardial infarction (MI) present with no obstructive coronary artery lesions. Until now, most studies have focused on acute coronary syndrome, including different clinical entities with a similar presentation encompassed under the term MI...

ver descrição completa

Detalhes bibliográficos
Autores: Vicente-Ibarra, Nuria, Feliu, Eloisa, Bertomeu-Martinez, Vicente, Cano-Vivar, Pedro, Carrillo-Saez, Pilar, Morillas, Pedro, Miguel Ruiz-Nodar, Juan
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2021
País:España
Recursos:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositório:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p7335
Acesso em linha:https://isabial.portalinvestigacion.com/publicaciones7335
Access Level:Acceso aberto
Palavra-chave:*Adverse cardiovascular events
*Cardiovascular magnetic resonance
*Myocardial infarction
*Myocardial infarction with no obstructive coronary arteries
id ES_03e0688fa3e18aebf8a75f7ad25bce7e
oai_identifier_str oai:isabial.fundanetsuite.com:p7335
network_acronym_str ES
network_name_str España
repository_id_str
spelling Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteriesVicente-Ibarra, NuriaFeliu, EloisaBertomeu-Martinez, VicenteCano-Vivar, PedroCarrillo-Saez, PilarMorillas, PedroMiguel Ruiz-Nodar, Juan*Adverse cardiovascular events*Cardiovascular magnetic resonance*Myocardial infarction*Myocardial infarction with no obstructive coronary arteriesBACKGROUND: It is estimated that 5% to 10% of patients with myocardial infarction (MI) present with no obstructive coronary artery lesions. Until now, most studies have focused on acute coronary syndrome, including different clinical entities with a similar presentation encompassed under the term MINOCA (MI with non-obstructive coronary arteries). The aim of this study is to assess the prognosis of patients diagnosed with true infarction, confirmed by cardiovascular magnetic resonance (CMR), in the absence of significant coronary lesions. METHODS: Prospective multicenter registry study, including 120 consecutive patients with a CMR-confirmed MI without obstructive coronary artery lesions. The primary clinical outcome was major adverse cardiovascular events (MACE: death, non-fatal infarction, stroke, or cardiac readmission), assessed over three years. RESULTS: Seventy-six patients (63.3%) were admitted with a diagnosis of acute coronary syndrome, and 44 (36.6%) for other causes (mainly heart failure); the definitive diagnosis was established by CMR. Most patients (64.2%) were men, and the mean age was 58.8 ± 13.5 years. Patients presented with small infarcts: 83 (69.1%) showed late gadolinium enhancement (LGE) in one or two myocardial segments, mainly transmural (in 77.5% of patients) and with a preserved left ventricular ejection fraction (median 54.8%, interquartile range 37-62). The most frequent infarct location was inferolateral (n = 38, 31.7%). During follow-up, 43 patients (35.8%) experienced a MACE, including 9 (7.5%) who died. In multivariable analysis, LGE in two versus one myocardial segment doubled the risk of adverse cardiac events (hazard ratio [HR] 2.32, 95% confidence interval [CI] 0.97-5.83, p = 0.058). Involvement of three or more myocardial segments almost tripled the risk (HR 2.71, 95% CI 1.04-7.04, p = 0.040 respectively). CONCLUSIONS: Patients with true MI but without significant coronary artery lesions predominantly had small infarcts. Myocardial 3-segment LGE involvement is associated with a significantly higher risk of adverse cardiac events.TAYLOR & FRANCIS INC2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones7335JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCEISSN: 10976647ISSNe: 1532429Xreponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p73352026-06-12T10:20:37Z
dc.title.none.fl_str_mv Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
title Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
spellingShingle Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
Vicente-Ibarra, Nuria
*Adverse cardiovascular events
*Cardiovascular magnetic resonance
*Myocardial infarction
*Myocardial infarction with no obstructive coronary arteries
title_short Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
title_full Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
title_fullStr Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
title_full_unstemmed Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
title_sort Role of cardiovascular magnetic resonance in the prognosis of patients with myocardial infarction with non-obstructive coronary arteries
dc.creator.none.fl_str_mv Vicente-Ibarra, Nuria
Feliu, Eloisa
Bertomeu-Martinez, Vicente
Cano-Vivar, Pedro
Carrillo-Saez, Pilar
Morillas, Pedro
Miguel Ruiz-Nodar, Juan
author Vicente-Ibarra, Nuria
author_facet Vicente-Ibarra, Nuria
Feliu, Eloisa
Bertomeu-Martinez, Vicente
Cano-Vivar, Pedro
Carrillo-Saez, Pilar
Morillas, Pedro
Miguel Ruiz-Nodar, Juan
author_role author
author2 Feliu, Eloisa
Bertomeu-Martinez, Vicente
Cano-Vivar, Pedro
Carrillo-Saez, Pilar
Morillas, Pedro
Miguel Ruiz-Nodar, Juan
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv *Adverse cardiovascular events
*Cardiovascular magnetic resonance
*Myocardial infarction
*Myocardial infarction with no obstructive coronary arteries
topic *Adverse cardiovascular events
*Cardiovascular magnetic resonance
*Myocardial infarction
*Myocardial infarction with no obstructive coronary arteries
description BACKGROUND: It is estimated that 5% to 10% of patients with myocardial infarction (MI) present with no obstructive coronary artery lesions. Until now, most studies have focused on acute coronary syndrome, including different clinical entities with a similar presentation encompassed under the term MINOCA (MI with non-obstructive coronary arteries). The aim of this study is to assess the prognosis of patients diagnosed with true infarction, confirmed by cardiovascular magnetic resonance (CMR), in the absence of significant coronary lesions. METHODS: Prospective multicenter registry study, including 120 consecutive patients with a CMR-confirmed MI without obstructive coronary artery lesions. The primary clinical outcome was major adverse cardiovascular events (MACE: death, non-fatal infarction, stroke, or cardiac readmission), assessed over three years. RESULTS: Seventy-six patients (63.3%) were admitted with a diagnosis of acute coronary syndrome, and 44 (36.6%) for other causes (mainly heart failure); the definitive diagnosis was established by CMR. Most patients (64.2%) were men, and the mean age was 58.8 ± 13.5 years. Patients presented with small infarcts: 83 (69.1%) showed late gadolinium enhancement (LGE) in one or two myocardial segments, mainly transmural (in 77.5% of patients) and with a preserved left ventricular ejection fraction (median 54.8%, interquartile range 37-62). The most frequent infarct location was inferolateral (n = 38, 31.7%). During follow-up, 43 patients (35.8%) experienced a MACE, including 9 (7.5%) who died. In multivariable analysis, LGE in two versus one myocardial segment doubled the risk of adverse cardiac events (hazard ratio [HR] 2.32, 95% confidence interval [CI] 0.97-5.83, p = 0.058). Involvement of three or more myocardial segments almost tripled the risk (HR 2.71, 95% CI 1.04-7.04, p = 0.040 respectively). CONCLUSIONS: Patients with true MI but without significant coronary artery lesions predominantly had small infarcts. Myocardial 3-segment LGE involvement is associated with a significantly higher risk of adverse cardiac events.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://isabial.portalinvestigacion.com/publicaciones7335
url https://isabial.portalinvestigacion.com/publicaciones7335
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv TAYLOR & FRANCIS INC
publisher.none.fl_str_mv TAYLOR & FRANCIS INC
dc.source.none.fl_str_mv JOURNAL OF CARDIOVASCULAR MAGNETIC RESONANCE
ISSN: 10976647
ISSNe: 1532429X
reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869402756191617024
score 15,81155

Registros relacionados