Sex Differences and Clinical Outcomes in Patients With Myocardial Infarction With Nonobstructive Coronary Arteries: A...

Area of Science:

• Cardiology
• Clinical Research
• Sex Differences in Medicine

Background:

• Myocardial infarction with nonobstructive coronary arteries (MINOCA) is more prevalent in women.
• Existing data is insufficient to determine if sex influences adverse outcomes in MINOCA patients.

Purpose of the Study:

• To investigate sex differences in long-term and short-term outcomes for patients diagnosed with MINOCA.

Main Methods:

• A systematic literature search was conducted across PubMed, Embase, and Cochrane databases up to August 2023.
• Nine studies involving 30,281 MINOCA patients (18,079 women, 12,202 men) were included.
• Pooled analysis used the Hartung-Knapp-Sidik-Jonkman random-effects model to compare outcomes.

Main Results:

• Women with MINOCA were older and had higher rates of hypertension, diabetes, and stroke.
• No significant differences were found in long-term risks of all-cause mortality, major adverse cardiovascular events (MACE), heart failure, stroke, or myocardial infarction between sexes.
• Women experienced a significantly higher risk of in-hospital MACE compared to men, though in-hospital mortality risk was similar.

Conclusions:

• Despite demographic and comorbidity disparities, sex does not significantly affect long-term outcomes in MINOCA patients.
• Women with MINOCA exhibit an increased risk of in-hospital MACE, highlighting a critical short-term sex-based difference.