Prognostic value of extracellular volume fraction in myocardial infarction and myocardial infarction with nonobstructive coronary arteries

Motivation: The prognosis of patients with myocardial infarction with nonobstructive coronary arteries (MINOCA) is not ideal, and prognostic stratification of ischemic MINOCA patients is still lacking. Goal(s): The aim of this study was to evaluate the prognostic role of the extracellular volume fraction (ECV) in patients with MI and MINOCA. Approach: From CMR imaging, the extent of late gadolinium enhancement (LGE), native T1 and ECV were derived. Follow-up was performed to assess major adverse cardiovascular events (MACEs). Results: ECV was an independent predictor of MACEs. Similarly, ECV maintained an independent association with MACEs in the MINOCA and obstructive MI groups. Impact: ECV demonstrated a strong prognostic association with MACEs and provided additional predictive value beyond common clinical and CMR risk factors. Furthermore, MINOCA is not a benign disease, their long-term prognosis is as poor as that of patients with obstructive MI.