Heart Attack Research Program- Imaging Study

Inclusion Criteria:

• Acute ischemic symptoms compatible with diagnosis of MI, such as chest pain or anginal equivalent symptoms at rest or new onset exertional anginal equivalent symptoms

• Objective evidence of MI (either or both of the following):

  • Elevation of troponin to above the laboratory upper limit of normal
  • ST segment elevation of ≥1mm on 2 contiguous ECG leads

• Willing to provide informed consent and comply with all aspects of the protocol

• Age ≥ 21 years

Exclusion Criteria:

• Stenosis ≥50% of any major epicardial vessel on invasive angiography, as determined by the angiographer at the time of clinically ordered cardiac catheterization
• History of known obstructive coronary artery disease at angiography, including history of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)
• Recent use of vasospastic agents, such as cocaine, triptans, or ergot alkaloids (≤1 month)
• Alternate explanation for troponin elevation, such as hypertensive urgency, acute exacerbation of heart failure, chronic elevation due to kidney disease, pulmonary embolism, cardiac trauma
• Coronary dissection apparent on angiography
• Excessive coronary tortuosity which, in the angiographer's opinion, increases the risks of OCT
• eGFR<45 or contraindication to additional contrast needed for OCT in the opinion of the angiographer or treating physician
• Contraindication to MRI (including but not limited to ferromagnetic implants)
• Pregnancy
• Thrombolytic therapy for STEMI (qualifying event)