SynthesisCirculation2015
Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries.
Synthesis in Circulation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 3 registered trials, which are not on this map. Cited by 430 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
PROgnostic Value of Precision Medicine in Patients With Myocardial Infarction and Non-obStructive Coronary artEries: the PROMISE Trial.
The Prognostic Role of Indices of Sympathetic Nervous System Overdrive in Patients With Myocardial Infarction With Non-obstructive Coronary Arteries
Implantable Cardiac Monitor to Detect Atrial Fibrillation in Patients With MINOCA
Who cites it
430 citing papers in PubMed, 6 syntheses or guidelines pooled it, 940 citations in OpenAlex.
- Clinical characteristics and outcomes in Takotsubo syndrome vs. spontaneous coronary artery dissection: a systematic review and meta-analysis.Cardiology journal · 2026Pooled it
- Understanding Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): a comprehensive meta-analysis of clinical characteristics, management, and prognosis compared to MI with the Obstructive Coronary Artery (MIOCA).BMC cardiovascular disorders · 2025Pooled it
- CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute coronary syndromes (ACS) in 2024.Cardiovascular intervention and therapeutics · 2024Guideline
- Sex Differences and Clinical Outcomes in Patients With Myocardial Infarction With Nonobstructive Coronary Arteries: A Meta-Analysis.Journal of the American Heart Association · 2024Pooled it
- Long term all-cause mortality after myocardial infarction with non-obstructed vs obstructed coronary artery disease: a meta-analysis of adjusted data.BMC cardiovascular disorders · 2024Pooled it
- Association Between Breast Arterial Calcification on Mammography and Coronary Artery Disease: A Systematic Review and Meta-Analysis.Journal of women's health (2002) · 2022Pooled it
- Stratified treatment of myocardial infarction with non-obstructive coronary arteries: the PROMISE trial.European heart journal · 2026Trial
- Biomarker Concentrations and Their Temporal Changes in Patients With Myocardial Infarction and Nonobstructive Compared With Obstructive Coronary Arteries: Results From the PLATO Trial.Journal of the American Heart Association · 2023Trial
- Agatston-2.0: A next-generation AI-based coronary calcium quantification approach to improve risk stratification among individuals with zero Agatston scores - Part I: An AI-CVD Study within the Multi-Ethnic Study of Atherosclerosis and Framingham Heart Study.American journal of preventive cardiology · 2026Article
- Sudden cardiac death in younger adults: a comparative analysis of coronary and non-coronary causes.International journal of cardiology. Heart & vasculature · 2026Article
- Diagnostic Value of Systemic Inflammatory Indices in Myocardial İnfarction With Non-Obstructive Coronary Arteries: Comparison With Obstructive Myocardial Infarction and Non-Critical Coronary Artery Disease.Cardiology research · 2026Article
- Health related quality of life and cardiac symptoms following admission for suspected MINOCA: A post-hoc analysis of the MINOCA-BAT randomized clinical trial.American heart journal plus : cardiology research and practice · 2026Article
- Redesigning cardiovascular medicine around sex differences.Nature medicine · 2026Review
- Intravascular imaging in myocardial infarction and ischemia with nonobstructive coronary arteries.Cardiovascular intervention and therapeutics · 2026Review
- Pheochromocytoma Masquerading as Acute Coronary Syndrome Complicated by Cardiogenic Shock: A CARE-Compliant Case Report.The American journal of case reports · 2026Article
- Molecular mechanisms of coronary microembolization-induced MINOCA.Basic research in cardiology · 2026Review
- From exercise to emergency-an extreme presentation of MINOCA: a case report.European heart journal. Case reports · 2026Article
- Myocardial Infarction Without Obstructive Coronary Disease in Later Life: Insights from the Malmö Diet and Cancer Study.Journal of clinical medicine · 2026Article
- Coronary Artery Disease in Women: Sex-Specific Pathophysiology, Risk Factors, Clinical Presentation and Management.Medicina (Kaunas, Lithuania) · 2026Review
- Etiologic classification of suspected MINOCA using cardiovascular magnetic resonance reports: a comparison of a large language model and human readers.The international journal of cardiovascular imaging · 2026Article
370 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Commented on by
- Erratum issuedCorrection.2015
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMyocardial infarction with nonobstructive coronary arteries (MINOCA) is a puzzling clinical entity with no previous evaluation of the literature. This systematic review aims to (1) quantify the prevalence, risk factors, and 12-month prognosis in patients with MINOCA, and (2) evaluate potential pathophysiological mechanisms underlying this disorder. METHODS AND
resultsQuantitative assessment of 28 publications using a meta-analytic approach evaluated the prevalence, clinical features, and prognosis of MINOCA. The prevalence of MINOCA was 6% [95% confidence interval, 5%-7%] with a median patient age of 55 years (95% confidence interval, 51-59 years) and 40% women. However, in comparison with those with myocardial infarction associated with obstructive coronary artery disease, the patients with MINOCA were more likely to be younger and female but less likely to have hyperlipidemia, although other cardiovascular risk factors were similar. All-cause mortality at 12 months was lower in MINOCA (4.7%; 95% confidence interval, 2.6%-6.9%) compared with myocardial infarction associated with obstructive coronary artery disease (6.7%, 95% confidence interval, 4.3%-9.0%). Qualitative assessment of 46 publications evaluating the underlying pathophysiology responsible for MINOCA revealed the presence of a typical myocardial infarct on cardiac magnetic resonance imaging in only 24% of patients, with myocarditis occurring in 33% and no significant abnormality in 26%. Coronary artery spasm was inducible in 27% of MINOCA patients, and thrombophilia disorders were detected in 14%.
conclusionsMINOCA should be considered as a working diagnosis with multiple potential causes that require evaluation so that directed therapies may improve its guarded prognosis.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.