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| Name | Class |
|---|---|
| Swedish Medical Research Council | UNKNOWN |
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Myocardial infarction with angiographically normal coronary arteries (MINCA) is common (7-8 % of all myocardial infarctions). There are several different causes behind MINCA where "true infarction" due to thromboembolism, myocarditis or Takotsubo stress cardiomyopathy are the main findings. The underlying diagnosis is often made by clinical findings sometimes with the help of cardiac MRI (CMR). Investigators have previously shown that it was possible to give 50 % of the patients a diagnosis made by the combination of clinical findings and CMR made in median 12 days after the acute event. The present study aim at improve the diagnostic accuracy by an early CMR with latest technique.
The present study aim at improve the diagnostic accuracy in MINCA with an CMR made 2-4 days after the acute event. The aim is to give 70 % of all patients with MINCA (35-70 years old) a definitive diagnosis made by CMR only. One-hundred and fifty patients will be included and compared with a similar historical sample where 50 % of the patients received a diagnosis made by a late CMR and clinical findings. The study has 80 % power to detect this 20 % absolute difference (p <0.05).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Prospective MINCA patients | Active Comparator | Patients with MINCA prospectively investigated with an early CMR with latest technique |
|
| Historical MINCA patients | Placebo Comparator | Patients with MINCA investigated earlier with a late CMR (median 12 days) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CMR | Procedure | Intervention performed 2-4 days after admission to hospital with the latest CMR technique including sensitive oedema sequences using T1 mapping |
|
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic accuracy of an early CMR with the latest technique | Show that the more patients get a definite diagnosis (70%) when compared to a historical sample (50%) | 2-4 days after admission |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with correct diagnosis with echocardiography | To study the accuracy of echocardiography compared to CMR using ROC | 12 months |
| Number of patients with a postive CT angiography and infarction on CMR |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Per Tornvall, MD, PhD | Karolinska Institutet | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Karolinska Institutet | Stockholm | Sweden |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38086910 | Derived | Steffen Johansson R, Tornvall P, Sorensson P, Nickander J. Reduced stress perfusion in myocardial infarction with nonobstructive coronary arteries. Sci Rep. 2023 Dec 13;13(1):22094. doi: 10.1038/s41598-023-49223-w. | |
| 37498255 | Derived | Sundqvist MG, Sorensson P, Ekenback C, Lundin M, Agewall S, Brolin EB, Cederlund K, Collste O, Daniel M, Jensen J, Y-Hassan S, Henareh L, Hofman-Bang C, Lynga P, Maret E, Sarkar N, Spaak J, Winnberg O, Caidahl K, Ugander M, Tornvall P. CMR Is Often Abnormal Despite Normal Echocardiography in Suspected Myocardial Infarction With Nonobstructed Coronary Arteries. JACC Cardiovasc Imaging. 2023 Dec;16(12):1626-1628. doi: 10.1016/j.jcmg.2023.05.024. Epub 2023 Jul 26. No abstract available. |
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| ID | Term |
|---|---|
| D009203 | Myocardial Infarction |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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To study CT angiography findings in relation to myocardial infarction shown by CMR
| 1 month |
| Describe QoL over time | 12 months |
| 36328780 | Derived | Berg E, Agewall S, Brolin EB, Caidahl K, Cederlund K, Collste O, Daniel M, Ekenback C, Jensen J, Y-Hassan S, Henareh L, Maret E, Spaak J, Sorensson P, Tornvall P, Lynga P. Health-related quality-of-life up to one year after myocardial infarction with non-obstructive coronary arteries. Eur Heart J Qual Care Clin Outcomes. 2023 Sep 12;9(6):639-644. doi: 10.1093/ehjqcco/qcac072. |
| 33865778 | Derived | Sorensson P, Ekenback C, Lundin M, Agewall S, Bacsovics Brolin E, Caidahl K, Cederlund K, Collste O, Daniel M, Jensen J, Y-Hassan S, Henareh L, Hofman-Bang C, Lynga P, Maret E, Sarkar N, Spaak J, Winnberg O, Ugander M, Tornvall P. Early Comprehensive Cardiovascular Magnetic Resonance Imaging in Patients With Myocardial Infarction With Nonobstructive Coronary Arteries. JACC Cardiovasc Imaging. 2021 Sep;14(9):1774-1783. doi: 10.1016/j.jcmg.2021.02.021. Epub 2021 Apr 14. |
| 28738781 | Derived | Tornvall P, Brolin EB, Caidahl K, Cederlund K, Collste O, Daniel M, Ekenback C, Jensen J, Y-Hassan S, Henareh L, Hofman-Bang C, Lynga P, Maret E, Sarkar N, Spaak J, Sundqvist M, Sorensson P, Ugander M, Agewall S. The value of a new cardiac magnetic resonance imaging protocol in Myocardial Infarction with Non-obstructive Coronary Arteries (MINOCA) - a case-control study using historical controls from a previous study with similar inclusion criteria. BMC Cardiovasc Disord. 2017 Jul 24;17(1):199. doi: 10.1186/s12872-017-0611-5. |
| D007238 |
| Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |