Evidence map›Paper›PMID 25587100›Full record

SynthesisCirculation2015

Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries.

Sivabaskari Pasupathy, Tracy Air, Rachel P Dreyer, Rosanna Tavella, John F Beltrame

Erratum issued 3 registry-linked trialsOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Circulation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 407 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
407citing papers in PubMed, 8 pooled it
32.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05122780 phase4unknown statusstarted 2021, after this paper: background citation

PROgnostic Value of Precision Medicine in Patients With Myocardial Infarction and Non-obStructive Coronary artEries: the PROMISE Trial.

Ran2021Enrolled120Registered outcomes17Posted comparisons0ConditionsMyocardial Infarction With Non-Obstructive Coronary ArteriesArmsACEi/ARB, Acetylcholine provocative test, Anticoagulant, Antiplatelet Drug, Beta Blocker
PMID 30772224PMID 32628045PMID 31709984PMID 31270616PMID 30913893PMID 30343094PMID 30266608PMID 29954744PMID 29228159PMID 28624816PMID 28476516PMID 28239487other papers from this trial
Open the trial in the graph
NCT04681612 unknown statusnot on this mapstarted 2019, after this paper: background citation

The Prognostic Role of Indices of Sympathetic Nervous System Overdrive in Patients With Myocardial Infarction With Non-obstructive Coronary Arteries

Typeobservational_patient_registrySponsorHippocration General HospitalRan2019 to 2023Enrolled150ConditionsMyocardial Infarction With Nonobstructive Coronary ArteriesArmsMSNA, Heart Rate Variability, Blood Pressure Variability, CMR, History, Lab, clinical and hemodynamic parameters
NCT05326828 recruitingnot on this mapstarted 2022, after this paper: background citation

Implantable Cardiac Monitor to Detect Atrial Fibrillation in Patients With MINOCA

TypeobservationalSponsorInsel Gruppe AG, University Hospital BernRan2022 to 2031Enrolled60ConditionsMINOCA, Atrial FibrillationArmsCONFIRM Rx implantable cardiac rhythm monitor (Abbott), Systematic etiologic work-up for underlying causes of MINOCA
3 · Its place in the literature

Who cites it

407 citing papers in PubMed, 8 syntheses or guidelines pooled it, 940 citations in OpenAlex.

  1. Pooled it
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  3. Guideline
  4. Pooled it
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  8. Brazilian Society of Cardiology Guideline on Myocarditis - 2022.Arquivos brasileiros de cardiologia · 2022
    Guideline
  9. Trial
  10. Trial
  11. Review
  12. Article
  13. Article
  14. Review
  15. Article
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  17. Article
  18. Guideline on Stress Echocardiography - 2026.Arquivos brasileiros de cardiologia · 2026
    Article
  19. Review
  20. Article

347 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Sivabaskari PasupathyFrom Discipline of Medicine, University of Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Cardiology Department, Queen Elizabeth Hospital, Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Discipline of Psychiatry, University of Adelaide, South Australia (T.A.); Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D.); Department of Internal Medicine, Yale School of Medicine, New Haven, CT (R.P.D.); and Cardiology Department, Lyell McEwin Hospital, Adelaide, South Australia (J.F.B.).
Tracy AirFrom Discipline of Medicine, University of Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Cardiology Department, Queen Elizabeth Hospital, Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Discipline of Psychiatry, University of Adelaide, South Australia (T.A.); Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D.); Department of Internal Medicine, Yale School of Medicine, New Haven, CT (R.P.D.); and Cardiology Department, Lyell McEwin Hospital, Adelaide, South Australia (J.F.B.).
Rachel P DreyerFrom Discipline of Medicine, University of Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Cardiology Department, Queen Elizabeth Hospital, Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Discipline of Psychiatry, University of Adelaide, South Australia (T.A.); Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D.); Department of Internal Medicine, Yale School of Medicine, New Haven, CT (R.P.D.); and Cardiology Department, Lyell McEwin Hospital, Adelaide, South Australia (J.F.B.).
Rosanna TavellaFrom Discipline of Medicine, University of Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Cardiology Department, Queen Elizabeth Hospital, Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Discipline of Psychiatry, University of Adelaide, South Australia (T.A.); Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D.); Department of Internal Medicine, Yale School of Medicine, New Haven, CT (R.P.D.); and Cardiology Department, Lyell McEwin Hospital, Adelaide, South Australia (J.F.B.).
John F BeltrameFrom Discipline of Medicine, University of Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Cardiology Department, Queen Elizabeth Hospital, Adelaide, South Australia (S.P., R.P.D., R.T., J.F.B.); Discipline of Psychiatry, University of Adelaide, South Australia (T.A.); Center for Outcomes Research and Evaluation (CORE), Yale-New Haven Hospital, New Haven, CT (R.P.D.); Department of Internal Medicine, Yale School of Medicine, New Haven, CT (R.P.D.); and Cardiology Department, Lyell McEwin Hospital, Adelaide, South Australia (J.F.B.). john.beltrame@adelaide.edu.au.
University of Adelaide · AUYale University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMyocardial infarction with nonobstructive coronary arteries (MINOCA) is a puzzling clinical entity with no previous evaluation of the literature. This systematic review aims to (1) quantify the prevalence, risk factors, and 12-month prognosis in patients with MINOCA, and (2) evaluate potential pathophysiological mechanisms underlying this disorder. METHODS AND

resultsQuantitative assessment of 28 publications using a meta-analytic approach evaluated the prevalence, clinical features, and prognosis of MINOCA. The prevalence of MINOCA was 6% [95% confidence interval, 5%-7%] with a median patient age of 55 years (95% confidence interval, 51-59 years) and 40% women. However, in comparison with those with myocardial infarction associated with obstructive coronary artery disease, the patients with MINOCA were more likely to be younger and female but less likely to have hyperlipidemia, although other cardiovascular risk factors were similar. All-cause mortality at 12 months was lower in MINOCA (4.7%; 95% confidence interval, 2.6%-6.9%) compared with myocardial infarction associated with obstructive coronary artery disease (6.7%, 95% confidence interval, 4.3%-9.0%). Qualitative assessment of 46 publications evaluating the underlying pathophysiology responsible for MINOCA revealed the presence of a typical myocardial infarct on cardiac magnetic resonance imaging in only 24% of patients, with myocarditis occurring in 33% and no significant abnormality in 26%. Coronary artery spasm was inducible in 27% of MINOCA patients, and thrombophilia disorders were detected in 14%.

conclusionsMINOCA should be considered as a working diagnosis with multiple potential causes that require evaluation so that directed therapies may improve its guarded prognosis.

Indexed as

Coronary VesselsFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedMyocardial InfarctionPrevalencePrognosisRisk FactorsSurvival Ratecoronary artery diseasecoronary vasospasmmagnetic resonancemortalitymyocardial infarctionphysiopathologythrombophilia

Identifiers

PMID25587100
OpenAlexW1964646781

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.