A Study on the Prognosis of Nonobstructive Coronary Artery Myocardial Infarction Evaluated by Cardiac Magnetic Resonance Imaging
Objective To explore the impact of cardiovascular magnetic resonance(CMR)on the prognosis of patients with non obstructive myocardial infarction(MINOCA)in coronary arteries.Methods An analysis was conducted on 388 MINOCA patients who underwent cardiac magnetic resonance(CMR)evaluation,and their primary clinical endpoints were prospectively tracked.Results Among 74％of patients(myocarditis,myocardial infarction,and cardiomyopathy),CMR(median 37 days)was able to determine the cause of elevated troponin,while the diagnostic rate of normal CMR was 26％.On average follow-up of 1262 days(3.5 years),5.7％of patients died.The prognosis of the cardiomyopathy group was the worst(mortality rate of 15％;pairwise test:19.9;P＜0.001),while the mortality rates of the myocarditis group and the normal cardiomyopathy group were 4％and 2％,respectively.In multivariate COX regression models(including clinical and CMR parameters),CMR diagnosis of cardiomyopathy and ST segment elevation on electrocardiogram remain the only two meaningful predictors of mortality.Using electrocardiogram ST segment elevation and myocardial infarction diagnosis as risk indicators,the mortality risk rates for 0,1,and 2 factors were 2％,11％,and 21％,respectively(P＜0.001).Conclusion Among MINOCA patients,CMR(median 37 days after onset)was determined as the final diagnosis in 74％of patients.The mortality rate of cardiomyopathy is the highest,followed by myocardial infarction.The strongest predictors of mortality are CMR diagnosis of cardiomyopathy and ST segment elevation on electrocardiogram.
Cardiovascular Magnetic Resonance ImagingCoronary Nonobstructive Myocardial InfarctionMyocarditis
万方数据
维普
