Back to The Future: How To Define Prognosis in MINOCA?

Myocardial Infarction with non-Obstructive Coronary Arteries (MINOCA) is the final diagnosis in 6-10% of all acute coronary syndromes (ACS). It is mostly present in female individuals. MINOCA was defined by the European Society of Cardiology (ESC) in 2017, and the Fourth Universal Definition of Myocardial Infarction (2018) further reinforced this concept. ,

Dreyer et al., analyzing Medicare data in the United States, determined an incidence for MINOCA of 5.9%. Lower rates of one-year MACE (1.7% vs 27.6%), mortality (12.3% vs 16.7%) and re-hospitalization for ACS (1.3% vs 6.1%) were observed in MINOCA compared with ACS with coronary obstruction. Although the prognosis of MINOCA seems to be better than conventional ACS, a better understanding of which conditions are associated with better or worse prognosis within the MINOCA spectrum is needed.

[…]