• Anais Hausvater, Sivabaskari Pasupathy, Per Tornvall, Himali Gandhi, Rosanna Tavella, John Beltrame, Stefan Agewall, Christina Ekenbäck, Elin Bacsovics Brolin, Judith S Hochman, Olov Collste, and Harmony R Reynolds.
• Soter Center for Women's Cardiovascular Research, Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, United States of America.
• Int. J. Cardiol. 2019 Jul 15; 287: 128-131.

PurposePatients with myocardial infarction and non-obstructive coronary arteries (MINOCA) may present with or without ST-elevation (STE) on the electrocardiogram (ECG). Previous studies have shown that STE was associated with higher risk of early mortality and long-term major adverse coronary events, and that cardiac magnetic resonance imaging (CMR) can help to determine whether the cause of a MINOCA presentation is ischemic or non-ischemic. We set out to determine the relationship between STE and CMR findings in patients presenting with MINOCA.DesignPatients who underwent CMR based on a provisional diagnosis of MINOCA were pooled from three prospective cohort studies: the multicenter Stockholm Myocardial Infarction with Normal Coronaries, a prospective University of Adelaide study, and a prospective NYU School of Medicine diagnostic imaging study. STE was defined as ≥1 mm in ≥2 contiguous leads.ResultsAmong 292 patients, average age was 57.0 years (±11.9), and 68% were female. Fifty-seven had STE, 231 had no STE and four had left bundle branch block. There was no difference between patients with vs. without STE in the likelihood of the CMR findings of infarction (21% vs. 18%), myocarditis (10% vs. 14%), left ventricular wall motion pattern consistent with takotsubo syndrome on CMR (16% vs. 14%).ConclusionSTE on the presenting ECG was not associated with CMR findings in patients with a provisional diagnosis of MINOCA. Based on these findings, increased risk among MINOCA patients with STE does not appear to be related to variation in these CMR findings.Copyright © 2019 Elsevier B.V. All rights reserved.

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