Clinical trial NCT06966531: Prevalence of Myocarditis in Patients Suspected Myocardial Infarction With Non-Obstructive Coronary Arteries
Official title: Prevalence of Myocarditis in Patients Suspected Myocardial Infarction With Non-Obstructive Coronary Arteries
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Prevalence of Myocarditis in MINOCA Patients
Keywords: Myocarditis
MINOCA
Normal coronary angiography
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2025-05-12
Enrollment: 148
Sex: ALL
Minimum age (years): 17
Maximum age (years): 80
Standard ages: CHILD
ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Study Population Description Myocardial infarction patients who were underwent PPCI and the coronary angiography showing insignificant lesions (stenosis less than 50% )

Brief summary: This study aims to determine the prevalence of myocarditis among patients suspected of having myocardial infarction with non-obstructive coronary arteries (MINOCA) and to analyze its clinical characteristics, diagnostic markers .

Detailed description: Acute myocardial infarction (AMI) remains the leading causes of high morbidity and mortality worldwide, Recently, a distinct population with myocardial infarction with nonobstructive coronary arteries (MINOCA) has been increasingly recognized because of the widespread use of coronary angiography. MINOCA occurs in 5%-10% of all AMI and they are younger and more often women compared to patients with AMI and obstructive coronary artery disease (CAD) , The underlying causes of MINOCA are manifold and may include plaque rupture or erosion, thromboembolism, coronary spasm, spontaneous dissection, microvascular dysfunction and supply/demand mismatch. Some non-ischemic diseases such as myocarditis may also mimic the presentation of MINOCA .Of note, several studies have found that the prognosis of MINOCA is not trivial and patients are still at considerable risks for long-term adverse cardiovascular (CV) events despite the optimal secondary prevention treatments \[\[6\], \[7\], \[8\], \[9\], \[10\]\]. Thus, it is of necessity and profound implications to find potential residual risk factors and improve prognosis in MINOCA population.

Myocarditis is commonly caused by viral infections, but it can also be caused by bacterial infections, toxic substances, or autoimmune disorders . Myocarditis is more common in younger patients, although it affects patients of all ages. Fulminant myocarditis, although rare, can result in life-threatening cardiogenic shock . Diagnosis of myocarditis is made using CMRI characterized by the presence of diffuse myocardial edema on T2 and with myocardial biopsy . In a meta-analysis of five observational studies with available CMRI data, one-third of MINOCA patients had myocarditis. It was more common in younger patients and those with high C-reactive protein .

Eligibility criteria: Inclusion Criteria:

* All patients; diagnosed with myocardial infarction with nonobstructive coronary arteries (MINOCA)
* clinical symptoms
* ECG : ischemic changes with or without ST segment elevation
* Echocardiograpy : segmental wall motion abnormalities (SWMA)
* positive cardiac enzymes
* Coronary angiography: insignificant lesions ,the absence of culprit obstructive coronary artery disease (epicardial coronary artery stenosis ≥50%)

Exclusion Criteria:

* Significant coronary artery disease (\>50% stenosis) on angiography.
* Prior history of myocarditis or cardiomyopathy.
* Contraindications to CMR (e.g., pacemakers, severe renal dysfunction).

Primary outcomes:
measure: Prevalence of myocarditis in patients presenting with MINOCA, as diagnosed by CMR.
timeFrame: 1 years
Secondary outcomes:
Other outcomes:
Locations:
Study officials:
affiliation: Cardiology department
name: Ayman khairy Mohamed Hassan
role: PRINCIPAL_INVESTIGATOR
affiliation: Cardiology department
name: Khaled Mohamed Abdullah Mohamed
role: PRINCIPAL_INVESTIGATOR
References: