Abstract 14322: Sex Differences and Clinical Outcomes in Patients With Myocardial Infarction With Non-Obstructive Coronary Arteries. A Meta-Analysis

Abstract

Introduction: While myocardial infarction with non-obstructive coronary arteries (MINOCA) is more common in women, it is unknown whether female sex is a risk factor for adverse outcomes in patients with MINOCA. We aimed to investigate the relationship between sex differences and outcomes of patients with MINOCA by a meta-analysis Methods: A systematic literature search was performed in PubMed, Embase and Cochrane databases from its inception until June 2, 2022 for relevant studies. Endpoints were pooled using the DerSimonian and Laird random-effects model as odd ratio (OR) with 95% confidence intervals (CI). Results: 6 studies with 28,383 patients with MINOCA (11,223 men, 17,160 women) were included in the analysis. There was no significant difference in terms of all-cause mortality (OR 1.03, 95% CI 0.91-1.17, p=0.66), major adverse cardiovascular events (MACE)(OR 0.87, 95% CI 0.74-1.02, p=0.09), incidence of heart failure (OR 1.09, 95% CI 0.89-1.34, p=0.42), stroke (OR 1.09, 95% CI 0.89-1.34, p=0.42) and myocardial infarction (OR 1.09, 95% CI 0.89-1.32, p=0.41). Subgroup analysis based on follow-up period showed that men had a lower risk of MACE than women in subgroups of less than 1 year (OR 0.75, 95% CI 0.65-0.87, p=0.41) compared to that of more than 1 year (OR 0.97, 95% CI 0.87-1.09). Conclusion: Apart from lower short-term risk of MACE in men, there appears to be no significant sex-specific differences in the outcomes among patients with MINOCA.