Table 5.
Cardiac investigations for ischemia and/or structural abnormalities in patients with undiagnosed myocardial infarction with no obstructive coronary arteries (MINOCA) vs ischemia with no obstructive coronary arteries (INOCA)
| Testing modality | MINOCA patients (n = 51) | INOCA patients (n = 112) | P | |
|---|---|---|---|---|
| Microvascular dysfunction provocation test with adenosine (CFR < 2.5 and/or IMR ≥ 25) | Positive | 2 (3.9) | 12 (10.7) | 0.20 |
| Negative | 4 (7.8) | 4 (3.6) | ||
| Not done | 45 (88.2) | 96 (85.7) | ||
| Epicardial vasospasm provocation test with ergonovine or acetylcholine (CFR < 1.5) | Positive | 3 (5.9) | 5 (4.5) | 0.59 |
| Negative | 0 | 2 (1.8) | ||
| Not done | 48 (94.1) | 105 (93.8) | ||
| Exercise stress test | Positive for ischemia | 3 (5.9) | 43 (38.4) | < 0.001 |
| Negative | 24 (47.1) | 54 (48.2) | ||
| Not done | 24 (47.1) | 15 (13.4) | ||
| Cardiac MRI | Positive for ischemia | 3 (5.9) | 6 (5.4) | 0.002 |
| Negative | 24 (47.1) | 23 (20.5) | ||
| Not done | 24 (47.1) | 83 (74.1) | ||
| Myocardial perfusion imaging | Positive for ischemia | 0 | 8 (7.1) | 0.006 |
| Negative | 6 (11.8) | 31 (27.7) | ||
| Not done | 45 (88.2) | 73 (65.2) | ||
| Highest stenosis from most recent CA and/or CTCA prior to baseline LDWHC appointment | Normal | 36 (70.6) | 68 (60.7) | 0.13 |
| Minimal (1%–24%) | 10 (19.6) | 17 (15.2) | ||
| Mild (25%–49%) | 5 (9.8) | 20 (17.9) | ||
| Not done | 0 | 7 (6.3) | ||
| Echocardiogram wall-motion findings | Normal | 29 (56.9) | 60 (53.6) | < 0.001 |
| Akinesis | 2 (3.9) | 0 | ||
| Dyskinesis | 0 | 1 (0.9) | ||
| Hypokinesis | 9 (17.6) | 3 (2.7) | ||
| Not assessed | 1 (2.0) | 0 | ||
| Not done | 10 (19.6) | 48 (42.9) | ||
All values, except P-values, are presented as n (%).
CA, coronary angiogram; CFR, coronary flow reserve; CMD, coronary microvascular dysfunction; CTCA, computed tomography coronary angiogram; IMR, index of microvascular resistance; MRI, magnetic resonance imaging; LDWHC, Leslie Diamond Women’s Heart Centre.