Table.
Demographics, Clinical Characteristics and Imaging Findings in Women With MINOCA Overall and in Relation to OCT and CMR Findings
| Variable | MINOCA participants with OCT interpretable (N=145) | OCT culprit present (N=67) | No OCT culprit (N=78) | P value | CMR abnormal (N=86) | CMR normal (N=30) | P value |
|---|---|---|---|---|---|---|---|
| Age, median [IQR], y | 59.6 [52.4, 69.4] |
66.05 [57.14, 72.61] |
55.96 [48.55, 64.36] |
<0.001 | 59.51 [49.83, 71.21] |
58.38 [53.38, 67.23] |
0.97 |
| Female sex, n (%) | 145 (100) | 67 (100) | 78 (100) | NA | 86 (100) | 30 (100) | NA |
| Race, n (%) | 0.185 | 0.122 | |||||
| American Indian or Alaska Native | 2 (1.4) | 2 (3.0) | 0 (0.0) | 1 (1.2) | 0 (0.0) | ||
| Asian | 12 (8.3) | 3 (4.5) | 9 (11.5) | 5 (5.8) | 5 (16.7) | ||
| Black or African American | 17 (11.7) | 10 (14.9) | 7 (9.0) | 9 (10.5) | 4 (13.3) | ||
| Native Hawaiian or other Pacific Islander | 1 (0.7) | (1.5) | 0 (0.0) | 0 (0.0) | 1 (3.3) | ||
| Other | 17 (11.7) | 9 (13.4) | 8 (10.3) | 11 (12.8) | 1 (3.3) | ||
| White | 96 (66.2) | 42 (62.7) | 54 (69.2) | 60 (69.8) | 19 (63.3) | ||
| Ethnicity, n (%) | |||||||
| Hispanic or Latino | 35 (24.1) | 16 (23.9) | 19 (24.4) | >0.99 | 21 (24.4) | 5 (16.7) | 0.534 |
| Medical history, n (%) | |||||||
| Hypertension | 66 (45.5) | 35 (52.2) | 31 (39.7) | 0.181 | 39 (45.3) | 13 (43.3) | >0.99 |
| Diabetes | 23 (15.9) | 18 (26.9) | 5 (6.4) | 0.002 | 12 (14.0) | 6 (20.0) | 0.621 |
| Dyslipidemia | 51 (35.2) | 33 (49.3) | 18 (23.1) | 0.002 | 31 (36.0) | 10 (33.3) | 0.963 |
| Smoking status | n=144 | n=66 | n=78 | 0.115 | n=86 | n=29 | 0.013 |
| Current smoker, n (%) | 16 (11.1) | 8 (12.1) | 8 (10.3) | 9 (10.5) | 6 (20.7) | ||
| Former smoker, n (%) | 31 (21.5) | 19 (28.8) | 12 (15.4) | 13 (15.1) | 10 (34.5) | ||
| Never smoker, n (%) | 97 (67.4) | 39 (59.1) | 58 (74.4) | 64 (74.4) | 13 (44.8) | ||
| Family history of MI, n/N (%) | 34/132 (25.8) | 18/59 (30.5) | 16/73 (21.9) | 0.357 | 16/80 (20.0) | 9/27 (33.3) | 0.249 |
| Prior MI, n (%) | 13 (9.0) | 8 (11.9) | 5 (6.4) | 0.384 | 7 (8.1) | 3 (10.0) | 0.717 |
| Depression, n/N (%) | 34/143 (23.8) | 14 (20.9) | 20/76 (26.3) | 0.573 | 20 (23.3) | 7/28 (25.0) | >0.99 |
| Anxiety, n/N (%) | 31/143 (21.7) | 15 (22.4) | 16/76 (21.1) | >0.99 | 17 (19.8) | 8/28 (28.6) | 0.475 |
| Symptoms at MI presentation | |||||||
| Chest pain, n (%) | 130 (89.7) | 60 (89.6) | 70 (89.7) | >0.99 | 77 (89.5) | 26 (86.7) | 0.736 |
| Arm pain, n (%) | 59 (40.7) | 28 (41.8) | 31 (39.7) | 0.936 | 38 (44.2) | 0.982 | |
| Duration of symptoms on the day of presentation, median [IQR], h | (n=137) 3.0 [1.0, 10.0] |
(n=61) 5.0 [1.0, 15.0] |
(n=76) 2.0 [1.0, 6.0] |
0.032 | (n=80) 3.5 [1.0, 10.0] |
(n=29) 2.0 [1.0, 8.0] |
0.287 |
| ST-elevation myocardial infarction presentation, n (%) | 5 (3.5) | 2/66 (3.2) | 3/77 (3.7) | >0.99 | 5/84 (6.0) | 0/30 (0.0) | 0.323 |
| Electrocardiogram findings (N=143), n (%) | n=67 | n=76 | n=86 | n=29 | |||
| ST depression | 15 (10.5) | 8 (11.9) | 7 (9.2) | 0.796 | 9 (10.5) | 3 (10.3) | >0.99 |
| T-wave inversion | 65 (45.5) | 30 (44.8) | 35 (46.1) | >0.99 | 44 (51.2) | 9 (31.0) | 0.096 |
| Left bundle-branch block | 2 (1.4) | 1 (1.5) | 1 (1.3) | >0.99 | 2 (2.3) | 0 (0.0) | 0.994 |
| Q waves | 27 (18.9) | 15 (22.4) | 12 (15.8) | 0.428 | 15 (17.4) | 4 (13.8) | 0.788 |
| Prolonged QTc interval | 40 (28.0) | 22 (32.8) | 18 (23.7) | 0.303 | 26 (30.2) | 9 (31.0) | >0.99 |
| Normal electrocardiogram | 50 (35.0) | 18 (26.9) | 32 (42.1) | 0.083 | 28 (32.6) | 11 (37.9) | 0.763 |
| Blood pressure (n=139) | |||||||
| Systolic blood pressure, median [IQR], mm Hg | 132.00 [121.00, 152.50] |
132.00 [121.25, 150.75] |
133.00 [121.00, 154.00] |
0.931 | 134.00 [121.00, 151.00] |
127.00 [113.00, 148.00] |
0.464 |
| Diastolic blood pressure, median [IQR], mm Hg | 78.00 [68.50, 87.00] |
76.00 [69.25, 86.00] |
78.00 [67.00, 87.00] |
0.846 | 79.00 [70.00, 87.00] |
70.00 [63.00, 78.00] |
0.009 |
| Echocardiography (N=111) | |||||||
| Segmental wall motion abnormality on echocardiogram, n (%) | 49/111 (44.1) | 25/53 (47.2) | 24/58 (41.4) | 0.121 | 35/66 (53.0) | 6/20 (30.0) | 0.121 |
| Left ventricular ejection fraction, median [IQR], % | (n=110) 59.5 [50.0, 63.0] |
(n=53) 60.0 [52.0, 62.0] |
(n=57) 59.0 [50.0, 64.0] |
0.945 | (n=67) 57.0 [45.5, 62.0] |
(n=18) 60.0 [55.3, 65.0] |
0.107 |
| Laboratory data | n=67 | n=78 | |||||
| Peak troponin, median [IQR], ng/mL | 0.94 [0.34, 4.38] |
0.75 [0.31, 3.54] |
1.18 [0.40, 4.55] |
0.398 | 1.79 [0.66, 6.53] |
0.52 [0.19, 0.92] |
<0.001 |
| Peak troponin, multiple of local upper limit of normal for the laboratory assay, median [IQR] | 17.25 [7.00, 61.00] |
17.25 [5.42, 57.92] |
17.25 [10.01, 73.19] |
0.526 | 37.95 [11.65, 112.14] |
9.47 [4.34, 14.61] |
<0.001 |
| Coronary angiography | n=67 | n=78 | n=86 | n=30 | |||
| Coronary angiogram reported as normal by site, n (%) | 77 (53.1) | 23 (34.3) | 54 (69.2) | <0.001 | 47 (54.7) | 12 (40.0) | 0.242 |
| Maximal diameter stenosis by core laboratory, median [IQR] | (n=142) 30% [26, 37] |
(n=67) 31% [26, 36] |
(n=75) 29% [26, 38] |
0.724 | (n=85) 29% [25, 38] |
(n=28) 33% [27, 38] |
0.348 |
| Maximal stenosis by visual estimation at core laboratory, n (%) | |||||||
| 0% | 0 (0) | 0 (0) | 0 (0) | 0.245 | 0 (0) | 0 (0) | 0.430 |
| 1% to 10% | 5 (3.4) | 1 (1.5) | 4 (5.1) | 5 (5.8) | 0 (0) | ||
| 11% to 30% | 90 (62.1) | 39 (58.2) | 51 (65.4) | 51 (59.3) | 17 (56.7) | ||
| 31% to 49% | 50 (34.5) | 27 (40.3) | 23 (29.5) | 30 (34.9) | 13 (43.3) | ||
| Study imaging (N=145) | |||||||
| Days from MI to OCT, median [IQR] | 2 [1, 3] | 2.00 [1.00, 3.00] | 1.00 [1.00, 3.00] | 0.03 | (n=86) 1.00 [1.00, 2.75] |
(n=30) 2.00 [1.00, 2.75] |
0.274 |
| OCT number of vessels imaged, n (%) | 0.017 | 0.845 | |||||
| 1 | 12 (8.3) | 3 (4.5) | 9 (11.5) | 6 (7.0) | 3 (10.0) | ||
| 2 | 47 (32.4) | 16 (23.9) | 31 (39.7) | 29 (33.7) | 10 (33.3) | ||
| 3 | 86 (59.3) | 48 (71.6) | 38 (48.7) | 51 (59.3) | 17 (56.7) | ||
| OCT culprit lesion present, n (%) | 67 (46.2) | 67 (100) | 78 (0) | NA | 39/86 (45.3) | 12/30 (40.0) | 0.673 |
| CMR completed and interpretable, n (%) | 116 (80) | 51 (76.1) | 65 (83.3) | 0.382 | 86/86 (100) | 30/30 (100) | NA |
| CMR abnormal, n (%) | 86/116 (74.1) | 39/51 (76.5) | 47/65 (72.3) | 0.768 | 86/86 (100) | 0/30 (0) | NA |
| Days from MI to CMR, median (IQR) | 6.00 [3.50, 9.00] |
(n=50) 6.00 [4.00, 9.75] |
(n=65) 6.00 [3.00, 8.00] |
0.665 | 6.00 [3.00, 7.50] |
8.00 [6.00, 11.50] |
0.002 |
CMR indicates cardiac magnetic resonance; IQR, interquartile range; MI, myocardial infarction; MINOCA, myocardial infarction with nonobstructive coronary arteries; NA, not applicable; and OCT, coronary optical coherence tomography.