American heart journal plus : cardiology research and practice · 2026
Health related quality of life and cardiac symptoms following admission for suspected MINOCA: A post-hoc analysis of the MINOCA-BAT randomized clinical trial.
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Lindahl Bertil, Nordenskjöld Anna, Pasupathy Sivabaskari, Tavella Rosanna, Agewall Stefan, Atar Dan, Baron Tomasz, Bergström Olle, Erlinge David, Gale Chris P, Jernberg Tomas, Håkansson Felicia, Johansson Pelle, Pais Javier López, Ravn-Fischer Annica, Reynolds Harmony, Somaratne Jithendra, Beltrame John
Аннотация
BACKGROUND: Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) accounts for 6-8% of all MIs and is more common in women than men. After an episode of MINOCA, patients may experience a substantial symptom burden and reduced health-related quality of life (HRQoL). The aim of this post-hoc analysis was to describe clinical characteristics, residual symptoms and HRQoL, including sex differences in patients with a working diagnosis of MINOCA and preserved left ventricular ejection fraction (LV-EF).
METHODS: Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment in MINOCA patients (MINOCA-BAT) was an international clinical trial. Patients with a working diagnosis of MINOCA and LV-EF ≥ 40% were randomized to beta-blocker versus no beta-blocker and ACEI/ARB versus no ACEI/ARB. The trial was prematurely terminated after 192 enrolled participants (median age 59; 63% women). Clinical events, symptoms and HRQoL (EQ-5D-3L) were assessed at 7 weeks and 12 months after the index event.
RESULTS: The cohort represented a low-risk population. At one year, one patient had died, one had a re-infarction, 14% reported chest pain and 9% dyspnea. Median EQ-5D index scores did not change significantly between 7 weeks and 12 months (0.86 vs. 0.78) and were comparable to age-matched general population norms. Women reported slightly lower HRQoL than men.
CONCLUSIONS: Patients with a working diagnosis of MINOCA and preserved LV-EF constitute a low-risk population and demonstrate a favorable prognosis with symptom resolution within one year. Their HRQoL appears broadly similar to that observed in the general population, with only modest differences between the sexes.
METHODS: Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment in MINOCA patients (MINOCA-BAT) was an international clinical trial. Patients with a working diagnosis of MINOCA and LV-EF ≥ 40% were randomized to beta-blocker versus no beta-blocker and ACEI/ARB versus no ACEI/ARB. The trial was prematurely terminated after 192 enrolled participants (median age 59; 63% women). Clinical events, symptoms and HRQoL (EQ-5D-3L) were assessed at 7 weeks and 12 months after the index event.
RESULTS: The cohort represented a low-risk population. At one year, one patient had died, one had a re-infarction, 14% reported chest pain and 9% dyspnea. Median EQ-5D index scores did not change significantly between 7 weeks and 12 months (0.86 vs. 0.78) and were comparable to age-matched general population norms. Women reported slightly lower HRQoL than men.
CONCLUSIONS: Patients with a working diagnosis of MINOCA and preserved LV-EF constitute a low-risk population and demonstrate a favorable prognosis with symptom resolution within one year. Their HRQoL appears broadly similar to that observed in the general population, with only modest differences between the sexes.