Baseline demographics—MINOCA versus MI with obstructive CAD
| Overall (n=23 783) | MINOCA (n=1599) | MI with obstructive CAD (n=22 184) | P value* | |
| Age (years) | 61.5±11.9 | 57.6±14.2 | 61.7±11.6 | <0.0001 |
| Male (%) | 17 519 (73.7) | 851 (53.2) | 16 668 (75.1) | <0.0001 |
| Presentation | ||||
| STEMI | 7137 (30.0) | 141 (8.8) | 6996 (31.5) | <0.0001 |
| NSTEMI | 16 646 (70.0) | 1458 (91.2) | 15 188 (68.5) | <0.0001 |
| Heart failure at presentation | 2001 (8.4) | 108 (6.8) | 1893 (8.5) | 0.013 |
| Grace score | 122.9±28.8 | 113.2±28.1 | 123.6±28.7 | <0.0001 |
| Heart rate at presentation (beats/min) | 74±14 | 74±14 | 74±14 | 0.18 |
| Systolic BP at presentation (mm Hg) | 134±22 | 132±21 | 134±22 | 0.0002 |
| Diastolic BP at presentation (mm Hg) | 79±13 | 77±1 | 79±13 | 0.0005 |
| Left ventricular ejection fraction (%) | 53±14 | 56±14 | 53±14 | <0.0001 |
| Diabetes mellitus (%) | 5602 (23.6) | 228 (14.3) | 5374 (24.2) | <0.0001 |
| Hypertension (%) | 14 349 (60.3) | 878 (54.9) | 13 471 (60.7) | <0.0001 |
| Dyslipidaemia (%) | 9833 (41.4) | 576 (36.0) | 9257 (41.7) | <0.0001 |
| Family history of premature CAD (%) | 5438 (22.9) | 348 (21.8) | 5090 (23.0) | 0.284 |
| Smokers (%)† | 8056 (33.9) | 396 (24.8) | 7660 (34.5) | <0.0001 |
| Previous MI (%) | 4333 (18.2) | 136 (8.5) | 4197 (18.9) | <0.0001 |
| Previous PCI (%) | 3561 (15.0) | 119 (7.4) | 3442 (15.5) | <0.0001 |
| Previous stroke (%) | 976 (4.1) | 32 (2.0) | 944 (4.3) | <0.0001 |
| Peripheral arterial disease (%) | 1142 (4.8) | 35 (2.2) | 1107 (5.0) | <0.0001 |
| Cancer (%) | 1024 (4.3) | 61 (3.8) | 963 (4.3) | 0.317 |
| Antithrombotics prior to randomisation (%) | ||||
| Aspirin | 9464 (39.8) | 530 (33.1) | 8934 (40.3) | <0.0001 |
| Clopidogrel | 5201 (21.9) | 290 (18.1) | 4911 (22.1) | <0.0001 |
| Unfractionated heparin | 17 832 (75.0) | 534 (33.4) | 17 298 (78.0) | <0.0001 |
| LMWH | 12 107 (50.9) | 785 (49.2) | 11 322 (51.0) | 0.145 |
| Fondaparinux | 1153 (4.8) | 95 (6.0) | 1058 (4.8) | 0.034 |
| Bivalirudin | 958 (5.6) | 3 (5.8) | 955 (5.6) | 0.947 |
| GP IIbIIa inhibitors | 7874 (33.1) | 180 (11.3) | 7694 (34.7) | <0.0001 |
| Fibrinolytics‡ | 725 (10.2) | 27 (19.1) | 698 (10.0) | <0.0001 |
| Antiplatelets after randomisation (%) | ||||
| Higher-dose ASA | 11 850 (49.8) | 793 (49.6) | 11 057 (49.8) | 0.848 |
| Lower-dose ASA | 11 933 (50.2) | 806 (50.4) | 11 127 (50.2) | 0.848 |
| Double-dose clopidogrel | 11 826 (49.7) | 814 (50.9) | 11 012 (49.6) | 0.328 |
| Standard-dose clopidogrel | 11 957 (50.3) | 785 (49.1) | 11 172 (50.4) | 0.328 |
| Other medication at discharge (%) | ||||
| Beta blockers | 18 924 (80.2) | 974 (61.2) | 17 950 (81.6) | <0.0001 |
| ACE inhibitors | 14 879 (63.1) | 756 (47.5) | 14 123 (64.2) | <0.0001 |
| AT-2 antagonists | 2337 (9.9) | 164 (10.3) | 2173 (9.9) | 0.590 |
| Ca channel blockers | 3285 (13.9) | 320 (20.1) | 2965 (13.5) | <0.0001 |
| Diuretics | 4933 (20.9) | 308 (19.3) | 4625 (21.0) | 0.110 |
| Nitrates | 850 (3.6) | 38 (2.4) | 812 (3.7) | 0.007 |
| Statins | 20 581 (87.3) | 1087 (68.3) | 19 494 (88.6) | <0.0001 |
| Other lipid-lowering agents | 1403 (6.0) | 69 (4.3) | 1334 (6.1) | 0.005 |
| Insulin | 1938 (8.2) | 72 | 1889 (8.6) | <0.0001 |
| Oral hypoglycaemic agents | 3716 (15.8) | 156 (9.8) | 3560 (16.2) | <0.0001 |
| NSAIDs | 1030 (4.4) | 72 (4.5) | 958 (4.4) | 0.755 |
| Proton pump inhibitors | 5189 (29.9) | 285 (26.3) | 4904 (30.1) | 0.009 |
| Baseline laboratories | ||||
| Platelets (×109/L) | 232 (194–276) | 241 (201–290) | 232 (194–275) | <0.0001 |
| Haemoglobin (g/dL) | 14.0±1.7 | 13.9±1.6 | 14.0±1.7 | 0.0007 |
| WBC (×109/L) | 9.6±3.6 | 9.0±3.4 | 9.7±3.6 | <0.0001 |
| Creatinine clearance (mL/min) | 80.9±26.2 | 83.7±27.0 | 80.7±26.2 | <0.0001 |
| Creatinine (μmol/L) | 89.7±26.1 | 84.1±25.5 | 90.1±26.1 | <0.0001 |
| Troponin I (μg/L) | 0.5 (0.1–2.3) | 0.5 (0.1–2.1) | 0.5 (0.1–2.4) | 0.1049 |
| Troponin T (μg/L) | 0.1 (0.0–0.4) | 0.1 (0.0–0.4) | 0.1 (0.0–0.4) | 0.0079 |
| CK-MB (U/L) | 22 (12–45) | 25 (14–39) | 22 (12–45) | 0.3059 |
| CK-MB (%) | 11 (6–16) | 12 (7–20) | 11 (6–16) | 0.0001 |
| Total CK (U/L) | 155 (88–336) | 162 (94–296) | 154 (88–340) | 0.7764 |
| Stents (%) | ||||
| Bare metal stents only | 9448 (39.7) | 27 (1.7) | 9421 (42.5) | 0.220 |
| Drug-eluting stents | 6857 (28.8) | 13 (0.8) | 6844 (30.8) | 0.220 |
| Vessels with CAD | – | |||
| Left main | 330 (1.9) | – | 330 (1.9) | 0.313 |
| One-vessel disease | 13 204 (76.6) | – | 13 204 (76.6) | <0.0001 |
| Two-vessel disease | 2365 (13.7) | – | 2365 (13.7) | 0.004 |
| Three-vessel disease | 1111 (6.4) | – | 1111 (6.4) | 0.058 |
| Saphenous vein/arterial graft | 479 (2.8) | – | 479 (2.8) | 0.222 |
| Visible angiographic thrombus before PCI | 5459 (32.8) | 23 (46.0) | 5436 (32.7) | 0.046 |
Data are mean (SD), median (IQR) or number (percentage), as appropriate.
*P values were based on Student’s t-tests, Mann-Whitney U tests or χ2 tests, as appropriate.
†Smokers were classified as current smokers.
‡As initial reperfusion strategy.
ASA, acetylsalicylic acid; BP, blood pressure; CAD, coronary artery disease; CK, creatine kinase; CK-MB, creatine kinase myocardial band; GP IIbIIa, glycoprotein IIb/IIIa; LMWH, low-molecular-weight heparin; MI, myocardial infarction; MINOCA, myocardial infarction with non-obstructive coronary arteries; NSAID, non-steroidal anti-inflammatory drug; NSTEMI, non-ST-segment elevation myocardial infarction; PCI, percutaneous coronary intervention; STEMI, ST-segment elevation myocardial infarction; WBC, white blood cell count.