Additional heart imaging valuable for women with unexplained heart attacks

November 14, 2020

DALLAS, Nov. 14, 2020 -- Diagnostic imaging techniques were able to find the underlying cause of heart attack in many women who had no major artery blockage, according to late- breaking research presented today at the American Heart Association's Scientific Sessions 2020. The virtual meeting is Friday, November 13-Tuesday, November 17, 2020, and is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science for health care worldwide.

Previous research has found that up to one in 10 heart attacks among adults is classified as MINOCA, or myocardial infarction with non-obstructive coronary arteries, as determined by an angiogram (heart x-ray). Women are three times more likely to have MINOCA than men, and these non-obstructive heart attacks are also twice as common in non-white patients than white patients.

The Women's Heart Attack Research Program (HARP) is an international, multi-center study to assess the mechanisms of MINOCA and to try to find the cause of the heart attack in these patients. The study enrolled 301 women who experienced a heart attack but who did not have prior obstructive coronary artery disease and had no visible blockages on an angiogram. Their median age was 60 years, and 50% were non-Hispanic whites.

"Our findings are important because women (or men) with MINOCA have historically been told that since the angiogram is OK, they never had a heart attack. This is entirely wrong for about two-thirds of the women who had both imaging tests, and misleading for one-quarter of the women because we found they had another problem that was not related to blood flow and could be diagnosed via cardiac MRI," said Harmony R. Reynolds, M.D., director of New York University Langone's Sarah Ross Soter Center for Women's Cardiovascular Research and an associate professor in the department of medicine at NYU Grossman School of Medicine in New York City.

In this study, women diagnosed with MINOCA received two additional imaging tests: The results of images from OCTs and cardiac MRIs explained why women had symptoms and blood tests consistent with heart attack for 84% of the study participants: "Our findings demonstrate that even if the angiogram does not show substantial artery blockage, when women have symptoms and blood test findings consistent with a heart attack, it is likely a true heart attack and not heart inflammation," Reynolds said. "Additional imaging tests can get to the root of the problem and help health care professionals make an accurate heart attack diagnosis for women and to ensure they receive timely treatment."

While the study was not a clinical trial assessing treatments, Reynolds noted, "The results set the stage for future research to find out why women are more likely than men to have MINOCA when they have a heart attack and for clinical trials of treatments."

Reynolds noted that this study suggests identification of the underlying etiology of MINOCA is feasible and has the potential to guide medical therapy for secondary prevention.
-end-
Co-authors are Akiko Maehara, M.D.; Raymond Kwong, M.D.; Tara Sedlak, M.D.; Jacqueline Saw, M.D.; Nathaniel Smilowitz, M.D.; Ehtisham Mahmud, M.D.; Janet Wei, M.D.; Kevin Marzo, M.D.; Mitsuaki Matsumura, M.D.; Ayako Seno, M.D.; Anais Hausvater, M.D.; Caitlin Giesler, M.D.; Nisha Jhalani, M.D.; Catalin Toma, M.D.; Bryan Har, M.D.; Dwithiya Thomas, M.D.; Laxmi S. Mehta, M.D.; Jeffrey Trost, M.D.; Puja Mehta, M.D.; Bina Ahmed, M.D.; Kevin R. Bainey, M.D.; Yuhe Xia, M.S.; Hua Zhong, Ph.D.; Binita Shah, M.D.; Michael Attubato, M.D.; Sripal Bangalore, M.D.; Louai Razzouk, M.D.; Noel Bairey Merz, M.D.; Ki Park, M.D.; Ellen Hada; and Judith S. Hochman, M.D. Author disclosures are in the abstract.

The study was funded by the American Heart Association through a grant from the Go Red for Women Strategically Focused Research Network.

Presentation:
Session LBS.03 - Current Challenges in Coronary and Valve Disease

Additional Resources:

Multimedia is available on the right column of the release
https://newsroom.heart.org/news/additional-heart-imaging-valuable-for-women-with-unexplained-heart-attacks?preview=1e4c2c4272a0b1ae77d46a3146cce034

Uncommon heart attack, found more often in women, needs a second look

AHA Scientific Statement:
Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease

For more news at AHA Scientific Sessions 2020, follow us on Twitter @HeartNews

Statements and conclusions of studies that are presented at the American Heart Association's scientific meetings are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and biotech companies, device manufacturers and health insurance providers are available here, and the Association's overall financial information is available here.

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Heart Attack Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Molecular imaging identifies link between heart and kidney inflammation after heart attack
Whole body positron emission tomography (PET) has, for the first time, illustrated the existence of inter-organ communication between the heart and kidneys via the immune system following acute myocardial infarction.

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.

Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.

Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.

How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.

Read More: Heart Attack News and Heart Attack Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.