Clinical decision-making in myocardial infarction with non-obstructive coronary arteries Circulatory System
Conditions
Interventions
The questionnaire to the treating consultant seeks to determine:
(a) the current working diagnosis
(b) certainty of diagnosis (Underlying aetiology felt to be plaque rupture, or uncertain [defined as a diagnostic certainty for the underlying
mechanism reported by the treating clinician of <=7 out o
Sponsors
South Tees Hospitals NHS Foundation Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Presentation with MINOCA (as per the 2016 ESC consensus statement definition) 2. Presence of diagnostic uncertainty* as to the underlying mechanism. 3. Treating clinician intends to further assess by CMR 4. Age >18 years *Diagnostic uncertainty is defined as at least some doubt on the part of the treating clinician as to the underlying mechanism for the MINOCA, and quantified as a certainty level =8 (range 1-10, with 1 being fully uncertain and 10 being fully certain)
Exclusion criteria
Exclusion criteria: 1. Treating cardiologist deems the diagnosis is already felt to be secure (=9 of the certainty scale which has a range 1-10) 2. CMR is contra-indicated or not planned 3. Type II myocardial infarction rather than MINOCA 4. Symptom onset >2 weeks prior to CMR 5. Pregnancy 6. Does not have capacity to consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Diagnosis and management assessment completed by the treating cardiologist before and after the patient has undergone the cardiac MRI (questionnaire assessment of working diagnosis, diagnostic certainty [scale 1 - 10] and clinical management) | — |
Secondary
| Measure | Time frame |
|---|---|
| Assessment completed by the treating cardiologist before and after the patient has undergone the cardiac MRI (questionnaire assessment of working diagnosis, diagnostic certainty [scale 1 - 10], and clinical management): 1. Diagnosis 2. Diagnostic certainty 3. Management 4. Incidence of recurrent myocardial infarction at 1 year measured using patient records 5. Incidence of clinically-significant bleeding (Bleeding Academic Research Consortium (BARC) Type II, III or V) at 1 year measured using patient records | — |
Countries
Australia, England, United Kingdom
Contacts
Public ContactAnthony;Nicola Donnelly;Cunningham
;
Outcome results
None listed