Highlights
- •Myocardial infarction and non-obstructive coronary arteries is poorly defined.
- •Malignancy in MINOCA is more frequent than in obstructive coronary arteries.
- •Malignancy in MINOCA relates to an unfavorable long-term prognosis.
Abstract
Background
The significance of malignancy in patients with myocardial infarction and non-obstructive
coronary arteries (MINOCA) is poorly defined. This study aimed at determining the
prevalence of malignancy and its association with long-term outcome in MINOCA.
Methods
We searched the MEDLINE, EMBASE, and CENTRAL databases up to March 31, 2020 to identify
studies reporting data on malignancy in full. We performed a random effects meta-analysis
of proportions and assessed statistical heterogeneity using the I2 statistic and meta-regression
analysis.
Results
A total of 9 studies including 26,636 patients (11,910 men and 14,726 women) were
selected for the meta-analysis. Of them, 655 patients (2.5%) had a diagnosis of malignancy
at presentation. Comparison of presenting features and outcome between patients with
MINOCA and patients with myocardial infarction and coronary artery disease (MI-CAD)
showed that malignancy was significantly more common in the former as compared with
the latter (p = 0.019). During a median follow-up of 39 months, 2,081 patients with MINOCA died
(7.8%). Meta-regression analysis demonstrated that long-term mortality was associated
with left ventricular ejection fraction (p = 0.0001; coefficient: -0.001; 95% CI: from -0.002 to 0.002), malignancy at presentation
(p = 0.01; coefficient: 0.001; 95% CI: from -0.001 to 0.001), and use of beta-blockers
during follow-up (p = 0.03; coefficient: 0.001; 95% CI: from -0.000 to 0.001).
Conclusion
This study shows that the prevalence of malignancy in patients with MINOCA is not
trivial and is significantly greater than in patients with MI-CAD. Malignancy is significantly
associated with an unfavorable long-term prognosis in MINOCA.
Keywords
Abbreviations:
cad (coronary artery disease), Mi (myocardial infarction), Minoca (myocardial infarction and non-obstructive coronary arteries)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 24, 2020
Accepted:
June 17,
2020
Received in revised form:
June 11,
2020
Received:
May 1,
2020
Identification
Copyright
© 2020 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
