Randomized pilot trial on optimal treatment strategy, myocardial changes, and prognosis of patients with myocardial infarction with non-obstructive coronary arteries (MINOCA)

Abstract Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) remains an unresolved challenge. Many different diagnostic approaches are often required to diagnose, confirm, and evaluate MINOCA. The prevalence can be as high as 13 % of all acute MI patients indicating that this condition is not rare. At this time, there have been no completed randomized clinical trials involving MINOCA patients, and a better understanding of the mechanisms and management of these patients is important. This exploratory analysis seeks to find possible etiologic factors, the value of novel biomarkers, and the effect of different treatment strategies in patients with MINOCA. Methods This prospective randomized pilot trial will include 150 patients with MINOCA. A thorough clinical, laboratory and imaging evaluation will be performed including novel biomarkers and modern imaging techniques (heart magnetic resonance imaging and noninvasive testing). The duration of the enrollment is 18 months, duration of the follow up is 12 months from the enrollment of the first patient. Results The trial is registered under www.clinicaltrials.gov: NCT04538924. The study is currently recruiting participants. Conclusions Since MINOCA is not a benign disease, the results of the current investigation could inform future diagnostic and therapeutic strategies and enhance the understanding of MINOCA patients.