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Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment for Post Infarct Angina in Patients With Myocardial Infarction With Non-obstructive Coronary Arteries : A MINOCA-BAT Sub Study Rationale and Design

Pasupathy, Sivabaskari (author)
Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA, Australia; Basil Hetzel Institute, Adelaide, SA, Australia,Univ Adelaide, Fac Hlth Sci, Adelaide, SA, Australia.;Cent Adelaide Local Hlth Network, Dept Cardiol, Adelaide, SA, Australia.;Basil Hetzel Inst, Adelaide, SA, Australia.
Lindahl, Bertil, 1957- (author)
Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
Tavella, Rosanna (author)
Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA, Australia; Basil Hetzel Institute, Adelaide, SA, Australia,Univ Adelaide, Fac Hlth Sci, Adelaide, SA, Australia.;Cent Adelaide Local Hlth Network, Dept Cardiol, Adelaide, SA, Australia.;Basil Hetzel Inst, Adelaide, SA, Australia.
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Nordenskjöld, Anna M., 1977- (author)
Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiology,Örebro Univ, Sch Med Sci, Dept Cardiol, Örebro, Sweden.
Zeitz, Christopher (author)
Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA, Australia; Basil Hetzel Institute, Adelaide, SA, Australia,Univ Adelaide, Fac Hlth Sci, Adelaide, SA, Australia.;Cent Adelaide Local Hlth Network, Dept Cardiol, Adelaide, SA, Australia.;Basil Hetzel Inst, Adelaide, SA, Australia.
Arstall, Margaret (author)
Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Northern Adelaide Local Health Network, Adelaide, SA, Australia,Univ Adelaide, Fac Hlth Sci, Adelaide, SA, Australia.;Northern Adelaide Local Hlth Network, Dept Cardiol, Adelaide, SA, Australia.
Worthley, Matthew (author)
Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA, Australia,Univ Adelaide, Fac Hlth Sci, Adelaide, SA, Australia.;Cent Adelaide Local Hlth Network, Dept Cardiol, Adelaide, SA, Australia.
Neil, Christopher (author)
Department of Medicine, University of Melbourne, Melbourne, VIC, Australia,Univ Melbourne, Dept Med, Melbourne, Vic, Australia.
Singh, Kuljit (author)
Department of Medicine, Griffith University, Gold Coast, QLD, Australia,Griffith Univ, Dept Med, Gold Coast, Qld, Australia.
Turner, Stuart (author)
Department of Cardiology, John Hunter Hospital, Newcastle, NSW, Australia,John Hunter Hosp, Dept Cardiol, Newcastle, NSW, Australia.
Rajwani, Adil (author)
Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia,Royal Perth Hosp, Dept Cardiol, Perth, WA, Australia.
Mooney, John (author)
Department of Cardiology, Gosford Hospital, Gosford, NSW, Australia,Gosford Hosp, Dept Cardiol, Gosford, NSW, Australia.
Beltrame, John F. (author)
Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA, Australia; Basil Hetzel Institute, Adelaide, SA, Australia,Univ Adelaide, Fac Hlth Sci, Adelaide, SA, Australia.;Cent Adelaide Local Hlth Network, Dept Cardiol, Adelaide, SA, Australia.;Basil Hetzel Inst, Adelaide, SA, Australia.
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Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, SA, Australia; Basil Hetzel Institute, Adelaide, SA, Australia Univ Adelaide, Fac Hlth Sci, Adelaide, SA, Australia;Cent Adelaide Local Hlth Network, Dept Cardiol, Adelaide, SA, Australia.;Basil Hetzel Inst, Adelaide, SA, Australia. (creator_code:org_t)
2021-10-08
2021
English.
In: Frontiers in Cardiovascular Medicine. - : Frontiers Media S.A.. - 2297-055X. ; 8
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Introduction: Myocardial infarction with non-obstructive coronary arteries (MINOCA) occurs in ~10% of all patients with acute myocardial infarction (AMI), with an over-representation amongst women. Remarkably, it is estimated that as many as 1 in 4 patients with MINOCA experience ongoing angina at 12 months despite having no flow-restricting stenoses in their epicardial arteries. This manuscript presents the rationale behind Randomized Evaluation of Beta Blocker and Angiotensin-converting enzyme inhibitors/Angiotensin Receptor Blocker Treatment (ACEI/ARB) for Post Infarct Angina in MINOCA patients-The MINOCA BAT post infarct angina sub study.Methods: This trial is a registry-based, randomized, parallel, open-label, multicenter trial with 2 × 2 factorial design. The primary aim is to determine whether oral beta blockade compared with no oral beta blockade, and ACEI/ARB compared with no ACEI/ARB, reduce post infarct angina in patients discharged after MINOCA without clinical signs of heart failure and with left ventricular ejection fraction ≥40%. A total of 664 patients will be randomized into four groups; (i) ACEI/ARB with beta blocker, (ii) beta blocker only, (iii) ACEI/ARB only, or (iv) neither ACEI/ARB nor beta blocker and followed for 12 months. Results: The trial is currently recruiting in Australia and Sweden. Fifty six patients have been recruited thus far. Both sexes were equally distributed (52% women and 48% men) and the mean age was 56.3 ± 9.9 years.Conclusions: It remains unclear whether conventional secondary preventive therapies are beneficial to MINOCA patients in regard to post infarct angina. Existing registry-based literature suggest cardioprotective agents are less likely to be used in MINOCA patients. Thus, results from this trial will provide insights for future treatment strategies and guidelines specific to MINOCA patients.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Keyword

Myocardial Infarction with Non Obstrucrive Coronary Arteries (MINOCA)
coronary angiogram
myocardial infarction
non-obstructive coronary artery disease (NOCAD)
normal coronary angiography

Publication and Content Type

ref (subject category)
art (subject category)

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