Loading…
Predictors of poor clinical outcomes in patients with acute myocardial infarction and non-obstructed coronary arteries (MINOCA)
To assess the characteristics and prognosis of patients with myocardial infarction and non-obstructed coronary arteries (MINOCA). MINOCA was defined as acute myocardial infarction (AMI) with angiographic coronary stenosis
Saved in:
| Published in: | International journal of cardiology 2018-09, Vol.267, p.41-45 |
|---|---|
| Main Authors: | , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c408t-54162f2b4e019332496d171b09d84c92782d941d8b8717e14c5aeb03803c75713 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c408t-54162f2b4e019332496d171b09d84c92782d941d8b8717e14c5aeb03803c75713 |
| container_end_page | 45 |
| container_issue | |
| container_start_page | 41 |
| container_title | International journal of cardiology |
| container_volume | 267 |
| creator | Ciliberti, Giuseppe Coiro, Stefano Tritto, Isabella Benedetti, Martina Guerra, Federico Del Pinto, Maurizio Finocchiaro, Gherardo Cavallini, Claudio Capucci, Alessandro Kaski, Juan Carlos Ambrosio, Giuseppe |
| description | To assess the characteristics and prognosis of patients with myocardial infarction and non-obstructed coronary arteries (MINOCA).
MINOCA was defined as acute myocardial infarction (AMI) with angiographic coronary stenosis |
| doi_str_mv | 10.1016/j.ijcard.2018.03.092 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2062828154</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0167527317372637</els_id><sourcerecordid>2062828154</sourcerecordid><originalsourceid>FETCH-LOGICAL-c408t-54162f2b4e019332496d171b09d84c92782d941d8b8717e14c5aeb03803c75713</originalsourceid><addsrcrecordid>eNp9kE1v3CAQhlGVqtkm_QdRxDE92AWMDVwiRat-REqbHtIzwgNWWNmwAdwqp_71stq0x57m8rwz7zwIXVDSUkKHD7vW78Ak2zJCZUu6lij2Cm2oFLyhoucnaFMx0fRMdKfobc47QghXSr5Bp0ypXrCBbdDv78lZDyWmjOOE9zEmDLMPHsyM41ogLi5jH_DeFO9CyfiXL4_YwFocXp7joYGvqA-TSVB8DNgEi0MMTRxzSSsUZzHEFINJz9ik4pKvG6--3n673968P0evJzNn9-5lnqEfnz4-bL80d_efb7c3dw1wIkvTczqwiY3cEaq6jnE1WCroSJSVHBQTklnFqZWjFFQ4yqE3biSdJB2IXtDuDF0d9-5TfFpdLnrxGdw8m-DimjUjA5NM0p5XlB9RSDHn5Ca9T36p7TUl-qBe7_RRvT6o16TTVX2NXb5cWMfF2X-hv64rcH0EXP3zp3dJZ6hKofpPDoq20f__wh_ExJc_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2062828154</pqid></control><display><type>article</type><title>Predictors of poor clinical outcomes in patients with acute myocardial infarction and non-obstructed coronary arteries (MINOCA)</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Ciliberti, Giuseppe ; Coiro, Stefano ; Tritto, Isabella ; Benedetti, Martina ; Guerra, Federico ; Del Pinto, Maurizio ; Finocchiaro, Gherardo ; Cavallini, Claudio ; Capucci, Alessandro ; Kaski, Juan Carlos ; Ambrosio, Giuseppe</creator><creatorcontrib>Ciliberti, Giuseppe ; Coiro, Stefano ; Tritto, Isabella ; Benedetti, Martina ; Guerra, Federico ; Del Pinto, Maurizio ; Finocchiaro, Gherardo ; Cavallini, Claudio ; Capucci, Alessandro ; Kaski, Juan Carlos ; Ambrosio, Giuseppe</creatorcontrib><description>To assess the characteristics and prognosis of patients with myocardial infarction and non-obstructed coronary arteries (MINOCA).
MINOCA was defined as acute myocardial infarction (AMI) with angiographic coronary stenosis <50%.Cardiomyopathies and myocarditis were — a priori — excluded from the study. Stenoses <30% were considered normal coronary arteries (NCA); stenoses ≥30% but <50% were considered mild coronary artery disease (MCAD). Patients were subdivided in 3 groups: I) NCA (0 vessels; stenosis <30%); II) 1–2 vessels showing MCAD and III) MCAD in 3 vessels or the left main stem (LMS).
From January 2006 to December 2014, 7935 consecutive AMI patients were entered into our institutional database;150 (2%) were diagnosed as having MINOCA. At a median follow-up of 7.1 years the composite end-point (cardiovascular death, AMI or acute coronary syndrome, heart failure, stroke) occurred in 23 patients (17.4%). Survival analysis showed no differences between NCA versus MCAD (p = 0.781). When assessed by distribution of CAD, group III had a lower event-free survival compared to group I and group II, respectively 54 ± 14%, 83 ± 4% and 90 ± 5% (p = 0.001). In a multivariate model, only 3 vessel disease or LMS involvement (HR = 23.5, 95% CI 2.59–173.49, P = 0.001) and high C-reactive protein at hospital admission (HR = 1.47, 95% CI 1.06–2.07, P = 0.005) were significant predictors of the study composite endpoint.
In patients with MINOCA, the presence of NCA or 1–2 vessel MCAD was associated with better long-term clinical outcomes compared with patients with MCAD affecting 3 vessels or the LMS. Increased CRP concentrations on hospital admission were also a marker of worse clinical outcome during follow-up.
•MINOCA is a challenging working diagnosis.•A new standard definition of MINOCA has recently been proposed.•MINOCA patients with MCAD affecting 3 vessels and/or the LMS have a guarded prognosis.•MINOCA patients with increased CRP levels may require more aggressive treatment.•Systematic assessment of both number of coronary vessels showing MCAD and CRP levels may improve prognostic scores in MINOCA patients.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2018.03.092</identifier><identifier>PMID: 29957262</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Acute coronary syndrome ; Acute myocardial infarction ; Aged ; Biomarkers - analysis ; C-reactive protein ; C-Reactive Protein - analysis ; Cause of Death ; Coronary Angiography - methods ; Coronary Artery Disease - complications ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - physiopathology ; Coronary Occlusion - diagnosis ; Coronary Occlusion - diagnostic imaging ; Coronary Vessels - diagnostic imaging ; Female ; Follow-Up Studies ; Heart Failure - epidemiology ; Heart Failure - etiology ; Humans ; Italy - epidemiology ; Long Term Adverse Effects - epidemiology ; Long Term Adverse Effects - etiology ; Male ; Middle Aged ; MINOCA ; Myocardial Infarction - diagnosis ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Outcome Assessment (Health Care) ; Predictive Value of Tests ; Prognosis ; Risk Factors ; Severity of Illness Index ; Stroke - epidemiology ; Stroke - etiology ; Survival Analysis</subject><ispartof>International journal of cardiology, 2018-09, Vol.267, p.41-45</ispartof><rights>2018 Elsevier B.V.</rights><rights>Copyright © 2018 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-54162f2b4e019332496d171b09d84c92782d941d8b8717e14c5aeb03803c75713</citedby><cites>FETCH-LOGICAL-c408t-54162f2b4e019332496d171b09d84c92782d941d8b8717e14c5aeb03803c75713</cites><orcidid>0000-0001-7531-6286 ; 0000-0001-5394-1312 ; 0000-0003-0026-7154 ; 0000-0001-9463-5055 ; 0000-0002-0027-009X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29957262$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ciliberti, Giuseppe</creatorcontrib><creatorcontrib>Coiro, Stefano</creatorcontrib><creatorcontrib>Tritto, Isabella</creatorcontrib><creatorcontrib>Benedetti, Martina</creatorcontrib><creatorcontrib>Guerra, Federico</creatorcontrib><creatorcontrib>Del Pinto, Maurizio</creatorcontrib><creatorcontrib>Finocchiaro, Gherardo</creatorcontrib><creatorcontrib>Cavallini, Claudio</creatorcontrib><creatorcontrib>Capucci, Alessandro</creatorcontrib><creatorcontrib>Kaski, Juan Carlos</creatorcontrib><creatorcontrib>Ambrosio, Giuseppe</creatorcontrib><title>Predictors of poor clinical outcomes in patients with acute myocardial infarction and non-obstructed coronary arteries (MINOCA)</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>To assess the characteristics and prognosis of patients with myocardial infarction and non-obstructed coronary arteries (MINOCA).
MINOCA was defined as acute myocardial infarction (AMI) with angiographic coronary stenosis <50%.Cardiomyopathies and myocarditis were — a priori — excluded from the study. Stenoses <30% were considered normal coronary arteries (NCA); stenoses ≥30% but <50% were considered mild coronary artery disease (MCAD). Patients were subdivided in 3 groups: I) NCA (0 vessels; stenosis <30%); II) 1–2 vessels showing MCAD and III) MCAD in 3 vessels or the left main stem (LMS).
From January 2006 to December 2014, 7935 consecutive AMI patients were entered into our institutional database;150 (2%) were diagnosed as having MINOCA. At a median follow-up of 7.1 years the composite end-point (cardiovascular death, AMI or acute coronary syndrome, heart failure, stroke) occurred in 23 patients (17.4%). Survival analysis showed no differences between NCA versus MCAD (p = 0.781). When assessed by distribution of CAD, group III had a lower event-free survival compared to group I and group II, respectively 54 ± 14%, 83 ± 4% and 90 ± 5% (p = 0.001). In a multivariate model, only 3 vessel disease or LMS involvement (HR = 23.5, 95% CI 2.59–173.49, P = 0.001) and high C-reactive protein at hospital admission (HR = 1.47, 95% CI 1.06–2.07, P = 0.005) were significant predictors of the study composite endpoint.
In patients with MINOCA, the presence of NCA or 1–2 vessel MCAD was associated with better long-term clinical outcomes compared with patients with MCAD affecting 3 vessels or the LMS. Increased CRP concentrations on hospital admission were also a marker of worse clinical outcome during follow-up.
•MINOCA is a challenging working diagnosis.•A new standard definition of MINOCA has recently been proposed.•MINOCA patients with MCAD affecting 3 vessels and/or the LMS have a guarded prognosis.•MINOCA patients with increased CRP levels may require more aggressive treatment.•Systematic assessment of both number of coronary vessels showing MCAD and CRP levels may improve prognostic scores in MINOCA patients.</description><subject>Acute coronary syndrome</subject><subject>Acute myocardial infarction</subject><subject>Aged</subject><subject>Biomarkers - analysis</subject><subject>C-reactive protein</subject><subject>C-Reactive Protein - analysis</subject><subject>Cause of Death</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Artery Disease - complications</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary Occlusion - diagnosis</subject><subject>Coronary Occlusion - diagnostic imaging</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - etiology</subject><subject>Humans</subject><subject>Italy - epidemiology</subject><subject>Long Term Adverse Effects - epidemiology</subject><subject>Long Term Adverse Effects - etiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>MINOCA</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Outcome Assessment (Health Care)</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Stroke - epidemiology</subject><subject>Stroke - etiology</subject><subject>Survival Analysis</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kE1v3CAQhlGVqtkm_QdRxDE92AWMDVwiRat-REqbHtIzwgNWWNmwAdwqp_71stq0x57m8rwz7zwIXVDSUkKHD7vW78Ak2zJCZUu6lij2Cm2oFLyhoucnaFMx0fRMdKfobc47QghXSr5Bp0ypXrCBbdDv78lZDyWmjOOE9zEmDLMPHsyM41ogLi5jH_DeFO9CyfiXL4_YwFocXp7joYGvqA-TSVB8DNgEi0MMTRxzSSsUZzHEFINJz9ik4pKvG6--3n673968P0evJzNn9-5lnqEfnz4-bL80d_efb7c3dw1wIkvTczqwiY3cEaq6jnE1WCroSJSVHBQTklnFqZWjFFQ4yqE3biSdJB2IXtDuDF0d9-5TfFpdLnrxGdw8m-DimjUjA5NM0p5XlB9RSDHn5Ca9T36p7TUl-qBe7_RRvT6o16TTVX2NXb5cWMfF2X-hv64rcH0EXP3zp3dJZ6hKofpPDoq20f__wh_ExJc_</recordid><startdate>20180915</startdate><enddate>20180915</enddate><creator>Ciliberti, Giuseppe</creator><creator>Coiro, Stefano</creator><creator>Tritto, Isabella</creator><creator>Benedetti, Martina</creator><creator>Guerra, Federico</creator><creator>Del Pinto, Maurizio</creator><creator>Finocchiaro, Gherardo</creator><creator>Cavallini, Claudio</creator><creator>Capucci, Alessandro</creator><creator>Kaski, Juan Carlos</creator><creator>Ambrosio, Giuseppe</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7531-6286</orcidid><orcidid>https://orcid.org/0000-0001-5394-1312</orcidid><orcidid>https://orcid.org/0000-0003-0026-7154</orcidid><orcidid>https://orcid.org/0000-0001-9463-5055</orcidid><orcidid>https://orcid.org/0000-0002-0027-009X</orcidid></search><sort><creationdate>20180915</creationdate><title>Predictors of poor clinical outcomes in patients with acute myocardial infarction and non-obstructed coronary arteries (MINOCA)</title><author>Ciliberti, Giuseppe ; Coiro, Stefano ; Tritto, Isabella ; Benedetti, Martina ; Guerra, Federico ; Del Pinto, Maurizio ; Finocchiaro, Gherardo ; Cavallini, Claudio ; Capucci, Alessandro ; Kaski, Juan Carlos ; Ambrosio, Giuseppe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-54162f2b4e019332496d171b09d84c92782d941d8b8717e14c5aeb03803c75713</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute coronary syndrome</topic><topic>Acute myocardial infarction</topic><topic>Aged</topic><topic>Biomarkers - analysis</topic><topic>C-reactive protein</topic><topic>C-Reactive Protein - analysis</topic><topic>Cause of Death</topic><topic>Coronary Angiography - methods</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary Occlusion - diagnosis</topic><topic>Coronary Occlusion - diagnostic imaging</topic><topic>Coronary Vessels - diagnostic imaging</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - etiology</topic><topic>Humans</topic><topic>Italy - epidemiology</topic><topic>Long Term Adverse Effects - epidemiology</topic><topic>Long Term Adverse Effects - etiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>MINOCA</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Outcome Assessment (Health Care)</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Stroke - epidemiology</topic><topic>Stroke - etiology</topic><topic>Survival Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ciliberti, Giuseppe</creatorcontrib><creatorcontrib>Coiro, Stefano</creatorcontrib><creatorcontrib>Tritto, Isabella</creatorcontrib><creatorcontrib>Benedetti, Martina</creatorcontrib><creatorcontrib>Guerra, Federico</creatorcontrib><creatorcontrib>Del Pinto, Maurizio</creatorcontrib><creatorcontrib>Finocchiaro, Gherardo</creatorcontrib><creatorcontrib>Cavallini, Claudio</creatorcontrib><creatorcontrib>Capucci, Alessandro</creatorcontrib><creatorcontrib>Kaski, Juan Carlos</creatorcontrib><creatorcontrib>Ambrosio, Giuseppe</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ciliberti, Giuseppe</au><au>Coiro, Stefano</au><au>Tritto, Isabella</au><au>Benedetti, Martina</au><au>Guerra, Federico</au><au>Del Pinto, Maurizio</au><au>Finocchiaro, Gherardo</au><au>Cavallini, Claudio</au><au>Capucci, Alessandro</au><au>Kaski, Juan Carlos</au><au>Ambrosio, Giuseppe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of poor clinical outcomes in patients with acute myocardial infarction and non-obstructed coronary arteries (MINOCA)</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2018-09-15</date><risdate>2018</risdate><volume>267</volume><spage>41</spage><epage>45</epage><pages>41-45</pages><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract>To assess the characteristics and prognosis of patients with myocardial infarction and non-obstructed coronary arteries (MINOCA).
MINOCA was defined as acute myocardial infarction (AMI) with angiographic coronary stenosis <50%.Cardiomyopathies and myocarditis were — a priori — excluded from the study. Stenoses <30% were considered normal coronary arteries (NCA); stenoses ≥30% but <50% were considered mild coronary artery disease (MCAD). Patients were subdivided in 3 groups: I) NCA (0 vessels; stenosis <30%); II) 1–2 vessels showing MCAD and III) MCAD in 3 vessels or the left main stem (LMS).
From January 2006 to December 2014, 7935 consecutive AMI patients were entered into our institutional database;150 (2%) were diagnosed as having MINOCA. At a median follow-up of 7.1 years the composite end-point (cardiovascular death, AMI or acute coronary syndrome, heart failure, stroke) occurred in 23 patients (17.4%). Survival analysis showed no differences between NCA versus MCAD (p = 0.781). When assessed by distribution of CAD, group III had a lower event-free survival compared to group I and group II, respectively 54 ± 14%, 83 ± 4% and 90 ± 5% (p = 0.001). In a multivariate model, only 3 vessel disease or LMS involvement (HR = 23.5, 95% CI 2.59–173.49, P = 0.001) and high C-reactive protein at hospital admission (HR = 1.47, 95% CI 1.06–2.07, P = 0.005) were significant predictors of the study composite endpoint.
In patients with MINOCA, the presence of NCA or 1–2 vessel MCAD was associated with better long-term clinical outcomes compared with patients with MCAD affecting 3 vessels or the LMS. Increased CRP concentrations on hospital admission were also a marker of worse clinical outcome during follow-up.
•MINOCA is a challenging working diagnosis.•A new standard definition of MINOCA has recently been proposed.•MINOCA patients with MCAD affecting 3 vessels and/or the LMS have a guarded prognosis.•MINOCA patients with increased CRP levels may require more aggressive treatment.•Systematic assessment of both number of coronary vessels showing MCAD and CRP levels may improve prognostic scores in MINOCA patients.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>29957262</pmid><doi>10.1016/j.ijcard.2018.03.092</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-7531-6286</orcidid><orcidid>https://orcid.org/0000-0001-5394-1312</orcidid><orcidid>https://orcid.org/0000-0003-0026-7154</orcidid><orcidid>https://orcid.org/0000-0001-9463-5055</orcidid><orcidid>https://orcid.org/0000-0002-0027-009X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-5273 |
| ispartof | International journal of cardiology, 2018-09, Vol.267, p.41-45 |
| issn | 0167-5273 1874-1754 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2062828154 |
| source | ScienceDirect Freedom Collection 2022-2024 |
| subjects | Acute coronary syndrome Acute myocardial infarction Aged Biomarkers - analysis C-reactive protein C-Reactive Protein - analysis Cause of Death Coronary Angiography - methods Coronary Artery Disease - complications Coronary Artery Disease - diagnosis Coronary Artery Disease - physiopathology Coronary Occlusion - diagnosis Coronary Occlusion - diagnostic imaging Coronary Vessels - diagnostic imaging Female Follow-Up Studies Heart Failure - epidemiology Heart Failure - etiology Humans Italy - epidemiology Long Term Adverse Effects - epidemiology Long Term Adverse Effects - etiology Male Middle Aged MINOCA Myocardial Infarction - diagnosis Myocardial Infarction - etiology Myocardial Infarction - mortality Outcome Assessment (Health Care) Predictive Value of Tests Prognosis Risk Factors Severity of Illness Index Stroke - epidemiology Stroke - etiology Survival Analysis |
| title | Predictors of poor clinical outcomes in patients with acute myocardial infarction and non-obstructed coronary arteries (MINOCA) |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-23T05%3A14%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Predictors%20of%20poor%20clinical%20outcomes%20in%20patients%20with%20acute%20myocardial%20infarction%20and%20non-obstructed%20coronary%20arteries%20(MINOCA)&rft.jtitle=International%20journal%20of%20cardiology&rft.au=Ciliberti,%20Giuseppe&rft.date=2018-09-15&rft.volume=267&rft.spage=41&rft.epage=45&rft.pages=41-45&rft.issn=0167-5273&rft.eissn=1874-1754&rft_id=info:doi/10.1016/j.ijcard.2018.03.092&rft_dat=%3Cproquest_cross%3E2062828154%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c408t-54162f2b4e019332496d171b09d84c92782d941d8b8717e14c5aeb03803c75713%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2062828154&rft_id=info:pmid/29957262&rfr_iscdi=true |