Early Comprehensive Cardiovascular Magnetic Resonance Imaging in Patients With Myocardial Infarction With Nonobstructive Coronary Arteries

• Published in: JACC. Cardiovascular imaging 2021-09, Vol.14 (9), p.1774-1783
• Main Authors: Sörensson, Peder, Ekenbäck, Christina, Lundin, Magnus, Agewall, Stefan, Bacsovics Brolin, Elin, Caidahl, Kenneth, Cederlund, Kerstin, Collste, Olov, Daniel, Maria, Jensen, Jens, Y-Hassan, Shams, Henareh, Loghman, Hofman-Bang, Claes, Lyngå, Patrik, Maret, Eva, Sarkar, Nondita, Spaak, Jonas, Winnberg, Oscar, Ugander, Martin, Tornvall, Per
• Format: Article
• Language: English
• Subjects: cardiac magnetic resonance; Medicin och hälsovetenskap; myocardial infarction; myocarditis; nonobstructive coronary arteries; takotsubo syndrome
• ISSN: 1936-878X; 1876-7591; 1876-7591
• DOI: 10.1016/j.jcmg.2021.02.021

The objective of the SMINC-2 (Stockholm Myocardial Infarction With Normal Coronaries 2) study was to determine if more than 70% of patients with myocardial infarction with nonobstructed coronary arteries (MINOCA), investigated early with comprehensive cardiovascular magnetic resonance (CMR), could receive a diagnosis entirely by imaging. The etiology of MINOCA is heterogeneous, including coronary, cardiac, and noncardiac causes. Patients with MINOCA, therefore, represent a diagnostic challenge where CMR is increasingly used. The SMINC-2 study was a prospective study of 148 patients with MINOCA imaged with 1.5-T CMR with T1 and extracellular volume mapping early after hospital admission, compared to 150 patients with MINOCA imaged using 1.5-T CMR without mapping techniques from the SMINC-1 study as historic controls. CMR was performed at a median of 3 (SMINC-2) versus 12 (SMINC-1) days after hospital admission. In total, 77% of patients received a diagnosis with CMR imaging in the SMINC-2 study compared to 47% in the SMINC-1 study (p