Myocardial Infarction (MI) with Non-Obstructive Coronary Arteries (MINOCA), occurring in 6-8% of MIs, refers to patients who experience a heart attack without obstructive coronary artery disease (CAD) or significant atherosclerosis. One of the challenges inherent to MINOCA lies in its propensity to mimic non-coronary-related pathologies, such as myocarditis or takotsubo. Thus, Cardiac Magnetic Resonance (MRI) imaging has been recommended as the central diagnostic tool for confirming MINOCA diagnosis while excluding the others. However, the resource-intensive nature of MRI, combined with its limited availability in hospitals, poses barriers to patient access and limits research activities that could produce significant impact. Therefore, this project's aim is to curate the largest dataset of suspected MINOCA patients with MRI, via a collaboration between Sweden's nationwide registry and South Australia's state-wide registry, to answer the following key questions: (i) What is prognosis of MINOCA, as confirmed by MRI? (ii) What are the characteristics and prognosis of patients who had MRI compared to those who did not? (iii) What clinical parameters are associated with MINOCA on MRI? This project will utilize DataSHIELD, an innovative platform that enables pooled statistical analysis of sensitive data without compromising individual-level privacy. This multicentre, comprehensive study will have a major impact on contemporary practice. It will be able to provide the significance of MINOCA diagnosis (myocardial scar on MRI), alongside identifying clinical factors associated with its occurrence and its correlation with long-term outcomes. This is crucial for informing clinical guidelines, policy decisions around reimbursement for MRI, and developing effective clinical trials to enhance the management of MRI-confirmed MINOCA patients
Study Type
OBSERVATIONAL
Enrollment
1,000
No CMR
University of Adelaide
Adelaide, South Australia, Australia
Percentage of Participants Experiencing Major Adverse Cardiovascular Events (MACE)
The proportion of participants experiencing the first occurrence of MACE, defined as all-cause mortality, cardiac mortality, myocardial infarction, unstable angina, heart failure hospitalization, or stroke following MINOCA.
Time frame: 36 Months
Percentage of Participants with All-Cause Mortality
Proportion of participants who experience death from any cause following MINOCA.
Time frame: 36 Months
Percentage of Participants with Cardiac Mortality
Proportion of participants who experience death due to a cardiac cause following MINOCA
Time frame: 36 Months
Percentage of Participants with Myocardial Infarction (Re-Infarction)
Proportion of participants who are re-admitted for myocardial infarction following MINOCA
Time frame: 36 Months
Percentage of Participants with Hospital admission for Unstable Angina
Proportion of participants who are admitted for unstable angina following MINOCA.
Time frame: 36 Months
Percentage of Participants Hospitalized for Heart Failure
The proportion of participants who require hospitalization due to heart failure following MINOCA
Time frame: 36 Months
Percentage of Participants Experiencing a Stroke
The proportion of participants who experience a stroke following MINOCA
Time frame: 36 Months
Percentage of Participants with All-Cause Mortality
Proportion of participants who experience death from any cause following MINOCA.
Time frame: 12 Months
Percentage of Participants with Cardiac Mortality
Proportion of participants who experience death due to a cardiac cause following MINOCA
Time frame: 12 Months
Percentage of Participants with Myocardial Infarction (Re-Infarction)
Proportion of participants who are re-admitted for myocardial infarction following MINOCA
Time frame: 12 Months
Percentage of Participants with Hospital admission for Unstable Angina
Proportion of participants who are admitted for unstable angina following MINOCA.
Time frame: 12 Months
Percentage of Participants Hospitalized for Heart Failure
The proportion of participants who require hospitalization due to heart failure following MINOCA
Time frame: 12 Months
Percentage of Participants Experiencing a Stroke
The proportion of participants who experience a stroke following MINOCA
Time frame: 12 Months
Percentage of Participants Presenting to the Emergency Department with Chest Pain
The proportion of participants who present to the emergency department with chest pain, expressed as a percentage of the total study population.
Time frame: 36 Months
Percentage of Participants Presenting to the Emergency Department with Chest Pain
The proportion of participants who present to the emergency department with chest pain, expressed as a percentage of the total study population.
Time frame: 12 Months
Percentage of Participants with Late Gadolinium Enhancement (LGE) Features on CMR Following suspected MINOCA
The proportion of participants with detectable LGE on cardiac magnetic resonance (CMR) , indicating myocardial fibrosis or necrosis.
Time frame: From CMR performed within 3 months from acute presentation
Percentage of Participants with Abnormal Tissue Characteristics on CMR in Suspected MINOCA
The proportion of participants with suspected MINOCA who exhibit abnormal myocardial tissue characteristics on CMR, including myocardial edema,
Time frame: From CMR performed within 3 months from acute presentation
Percentage of Participants with Evidence of Myocarditis on CMR in Suspected MINOCA
The proportion of participants with suspected MINOCA who have CMR findings consistent with myocarditis (e.g., myocardial edema, LGE patterns suggestive of inflammation).
Time frame: From CMR performed within 3 months from acute presentation
Percentage of Participants with Evidence of Takotsubo Syndrome on CMR in Suspected MINOCA
The proportion of participants with suspected MINOCA who demonstrate CMR findings consistent with Takotsubo syndrome (e.g., apical ballooning, absence of LGE).
Time frame: From CMR performed within 3 months from acute presentation
Percentage of Participants with Normal CMR Findings in Suspected MINOCA
The proportion of participants with suspected MINOCA who have no significant abnormalities on CMR, indicating no structural or ischemic myocardial injury.
Time frame: From CMR performed within 3 months from acute presentation
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