Sex was not associated with differences in in-hospital mortality or all-cause death at follow-up (OR 0.93; 95% CI 0.76-1.13) among patients with MINOCA.
Meta-Analysis (n=42,870)
Does sex influence in-hospital and follow-up mortality or MACE in patients with MINOCA?
This meta-analysis demonstrates that despite MINOCA being more prevalent in women, sex does not significantly influence in-hospital or long-term all-cause mortality.
Effect estimate: OR 0.93 (95% CI 0.76-1.13)
Abstract Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is more prevalent in women than men, yet the impact of sex on prognosis remains uncertain. Objective To evaluate sex-related differences in overall mortality and major adverse cardiovascular events (MACE) during hospitalization and follow-up among MINOCA patients. Methods A detailed search of PubMed, EMBASE, and Cochrane databases was conducted through the end of 2024. Eligible prospective and retrospective studies evaluating the association between sex and adverse clinical outcomes in MINOCA patients were included. Independent screening, data extraction, and quality assessment were performed. All studies were meta-analyzed using a random-effect model. Main Outcomes for in-hospital (all-cause mortality) and at follow-up (all-cause mortality) outcomes in the overall pooled populations and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results Fifteen studies comprising 42,870 patients (58.7% women; mean age 62.0 ± 3.7 years) were analyzed. A total of 277 patients died during hospitalization, and 2236 deaths occurred during a mean follow-up of 3.5 ± 0.9 years. Pooled analyses (picture 1) demonstrated no sex differences in in-hospital mortality (OR: 1.05, 95% CI 0.82–1.34, I2 = 0%) or all-cause death at follow-up (OR: 0.93, 95% CI: 0.76–1.13, I2 = 54%). Conclusions Sex does not seem to influence the prognosis of MINOCA.
Herrera et al. (2025) conducted a meta-analysis in Myocardial infarction with non-obstructive coronary arteries (MINOCA) (n=42,870). Female sex vs. Male sex was evaluated on all-cause death at follow-up (OR 0.93, 95% CI 0.76-1.13). Sex was not associated with differences in in-hospital mortality or all-cause death at follow-up (OR 0.93; 95% CI 0.76-1.13) among patients with MINOCA.