Role of cardiac magnetic resonance in MINOCA: retrospective study in a single center (RF_SA_441)

Myocardial infarction with non-obstructive coronary arteries (MINOCA) presents a diagnostic challenge, as standard coronary angiography reveals no significant blockages despite the presence of myocardial injury. Cardiac magnetic resonance (CMR) imaging offers a non-invasive method to detect underlying pathologies that may contribute to this condition and is increasingly recommended by all the current guidelines. This study explores the impact of CMR on the evaluation of initial diagnoses in MINOCA patients during the past 5 years in our center.

Objectives

The purpose of this study was to characterize the MINOCA population in our center and to determine the diagnostic value of CMR in the management of these patients during the past 5 years.

 

Methods:

A retrospective observational study was conducted to review CMR performed at our center over the past five years (2019-2023). The study included all adult patients who underwent CMR during that period. Relevant clinical and imaging data were extracted from electronic medical records. Variables of interest included patient demographics, clinical indications for CMR (e.g., evaluation of myocardial infarction, cardiomyopathy), admission and discharge dates and imaging findings.

Results:

A total of 76 adult patients with MINOCA underwent CMR imaging at our center from 2019 to 2023. The mean age of the population was 58±14 years, with a gender distribution of 62% male and 38% female.

The average length of hospitalization was 4.7±3.2 days, with a range of 2 to 28 days. CMR was performed on average on day 2.7±1. There was a tendency to perform CMR earlier throughout those 5 years, the difference between 2019 and 2023 being significant.

The most frequent diagnosis after CMR were myocarditis (45%), myocardial infarction (16%) and Takotsubo (10%), while 14% of examinations were normal. In 70% of the cases the diagnosis obtained with CMR was different from the clinical diagnosis at admission, leading to changes in management.

Conclusion:

This retrospective observational study underscores the relevance of CMR in the evaluation and management of adult patients with MINOCA. According to the guidelines, CMR is performed earlier during the hospitalization in our center comparing 2019 with 2023. The findings indicate that CMR is a valuable diagnostic tool, providing results that often lead to changes in patient management.