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Heart, Lung and Circulation

Incidence and Clinical Predictors of Non-Obstructive Coronary Arteries in Patients With Suspected Non-ST Elevation Myocardial Infarction Undergoing Invasive Coronary Angiography

Published:April 29, 2022DOI:https://doi.org/10.1016/j.hlc.2022.03.009
      Invasive coronary angiography (ICA) is the standard of care for the management of patients with non-ST elevation myocardial infarction (NSTEMI) [
      • Amsterdam E.
      • Wenger N.
      • Brindis R.
      2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
      ,
      • Collet J.P.
      • Thiele H.
      • Barbato E.
      • Bauersachs J.
      • Dendale P.
      • Edvardsen T.
      • et al.
      2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation [Internet].
      ]. However, up to a third of patients do not undergo any form of revascularisation following ICA [

      Birkhead J, Weston C, Chen R. Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the myocardial ischaemia national audit project (MINAP). Heart. 2009t;95(19):1593-9.

      ] which includes patients with myocardial infarction with non-obstructive coronary arteries (MINOCA), MINOCA mimics, such as myocarditis and stress cardiomyopathy or type 2 myocardial infarction (MI). We therefore conducted a retrospective study to determine the proportion of patients with a suspected diagnosis of NSTEMI who had non-obstructive coronary arteries (NOCA) following ICA in a large volume tertiary centre and the clinical predictors of NOCA.

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      References

        • Amsterdam E.
        • Wenger N.
        • Brindis R.
        2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.
        J Am Coll Cardiol. 2014; 64: e139-e228
        • Collet J.P.
        • Thiele H.
        • Barbato E.
        • Bauersachs J.
        • Dendale P.
        • Edvardsen T.
        • et al.
        2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation [Internet].
        Eur Heart J. 2021; 42 (Available from:): 1289-1367
      1. Birkhead J, Weston C, Chen R. Determinants and outcomes of coronary angiography after non-ST-segment elevation myocardial infarction. A cohort study of the myocardial ischaemia national audit project (MINAP). Heart. 2009t;95(19):1593-9.