Assessing Coronary Microvascular Dysfunction in Myocardial Infarction Without Major Artery Blockage and Its Impact on Patient Outcomes

What this Trial Is About

Researchers are investigating myocardial infarction with non-obstructive coronary arteries MINOCA, a condition affecting about 5-10% of acute myocardial infarction patients. The study focuses on coronary microvascular dysfunction CMD, which is considered a major cause of MINOCA, and evaluates clinical outcomes based on CMD presence. This observational study aims to clarify the different causes of MINOCA and their impact on patient prognosis, addressing the challenges in diagnosis and management. The study uses diagnostic tests including intravascular imaging with optical coherence tomography OCT, invasive physiologic assessments like fractional flow reserve FFR, coronary flow reserve CFR, and index of microcirculatory resistance IMR, as well as non-invasive assessments using N-13 ammonia positron emission tomography PET. Participants are grouped into those with CMD and those without CMD, and assessments are performed to evaluate coronary microvascular function following the latest diagnostic guidelines. Participants will be monitored over a two-year period to assess major adverse cardiac and cerebrovascular events MACCE, including cardiac death, all-cause death, myocardial infarction, repeat revascularization, stroke, and heart failure readmission. Additional measurements include changes in left ventricular ejection fraction and coronary flow reserve. Data collection includes invasive and non-invasive imaging and physiologic tests, with regular follow-up to evaluate long-term clinical outcomes.

Coronary Microvascular Dysfunction Assessments in Myocardial Infarction With Non-Obstructive Coronary Arteries