Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)

Objetivos: Evaluar el impacto de la resonancia magnética cardíaca en el diagnóstico, manejo terapéutico y pronóstico de pacientes con infarto agudo de miocardio y aterosclerosis coronaria no obstructiva (MINOCA). Métodos: Estudio de cohorte ambispectivo que incluyó a 78 participantes diagnosticados...

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Autores:: Gasca Zuluaga, Daniel Andres
Rodriguez Pulido, Astrid Lorena

Tipo de recurso:: https://purl.org/coar/resource_type/c_7a1f

Fecha de publicación:: 2025

Institución:: Universidad El Bosque

Repositorio:: Repositorio U. El Bosque

Idioma:: eng

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dc.title.none.fl_str_mv	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)
dc.title.translated.none.fl_str_mv	Impact of cardiac magnetic resonance on the diagnosis, treatment, and outcomes of patients with acute myocardial infarction with non-obstructive coronary artery disease (MINOCA)
title	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)
spellingShingle	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA) Infarto agudo de miocardio Enfermedad coronaria Infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva Miocarditis Cardiomiopatia de Takotsubo Evento cardiovascular adverso mayor Resonancia magnetica nuclear Myocardial Infarction Coronary Artery Disease Myocardial Infarction and Non-obstructed Coronary Arteries Myocarditis Takotsubo Cardiomyopathy Major Adverse Cardiovascular Events Therapeutic Management Magnetic Resonance Imaging WG 100
title_short	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)
title_full	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)
title_fullStr	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)
title_full_unstemmed	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)
title_sort	Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)
dc.creator.fl_str_mv	Gasca Zuluaga, Daniel Andres Rodriguez Pulido, Astrid Lorena
dc.contributor.advisor.none.fl_str_mv	Carvajal Tascon, Carlos Andres
dc.contributor.author.none.fl_str_mv	Gasca Zuluaga, Daniel Andres Rodriguez Pulido, Astrid Lorena
dc.contributor.orcid.none.fl_str_mv	Gasca Zuluaga, Daniel Andres [0000-0003-0357-6796]
dc.subject.none.fl_str_mv	Infarto agudo de miocardio Enfermedad coronaria Infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva Miocarditis Cardiomiopatia de Takotsubo Evento cardiovascular adverso mayor Resonancia magnetica nuclear
topic	Infarto agudo de miocardio Enfermedad coronaria Infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva Miocarditis Cardiomiopatia de Takotsubo Evento cardiovascular adverso mayor Resonancia magnetica nuclear Myocardial Infarction Coronary Artery Disease Myocardial Infarction and Non-obstructed Coronary Arteries Myocarditis Takotsubo Cardiomyopathy Major Adverse Cardiovascular Events Therapeutic Management Magnetic Resonance Imaging WG 100
dc.subject.keywords.none.fl_str_mv	Myocardial Infarction Coronary Artery Disease Myocardial Infarction and Non-obstructed Coronary Arteries Myocarditis Takotsubo Cardiomyopathy Major Adverse Cardiovascular Events Therapeutic Management Magnetic Resonance Imaging
dc.subject.nlm.none.fl_str_mv	WG 100
description	Objetivos: Evaluar el impacto de la resonancia magnética cardíaca en el diagnóstico, manejo terapéutico y pronóstico de pacientes con infarto agudo de miocardio y aterosclerosis coronaria no obstructiva (MINOCA). Métodos: Estudio de cohorte ambispectivo que incluyó a 78 participantes diagnosticados con MINOCA entre 2019 y 2024, sometidos a resonancia magnética cardíaca. Se excluyeron pacientes con enfermedad coronaria conocida o intervenida previamente, así como con cardiomiopatías hipertróficas o infiltrativas. El desenlace primario fue la aparición de eventos cardiovasculares adversos mayores (MACE) durante un seguimiento de 12 meses. Resultados: La comorbilidad más frecuente fue dislipidemia (45%). La resonancia magnética permitió clasificar etiologías en la mayoría de los casos, destacando la miocarditis (41%) como la más frecuente. La fracción de eyección del ventrículo izquierdo (FEVI) fue significativamente menor en pacientes con Takotsubo. El realce tardío fue más común en miocarditis (78%), con distribución predominantemente subepicárdica y mesocardia. La resonancia modificó el manejo terapéutico en altos porcentajes: Takotsubo (100%), IAM tipo 2 (79%), miocarditis (75%), lesión miocárdica (80%) e INOCA (45%). Los eventos MACE ocurrieron exclusivamente en pacientes con INOCA (18%; p=0.0522), incluyendo un caso de accidente cerebrovascular/infarto (4.5%) y tres hospitalizaciones por causas cardiovasculares (14%). Conclusiones: La resonancia magnética cardíaca fue una herramienta diagnóstica fundamental en pacientes con MINOCA, permitiendo una reclasificación etiológica precisa en la mayoría de los casos y facilitando ajustes terapéuticos en un rango entre el 75% y 100%. La baja incidencia de eventos adversos y la ausencia de mortalidad en el seguimiento sugieren un pronóstico favorable a corto plazo en esta cohorte.
publishDate	2025
dc.date.accessioned.none.fl_str_mv	2025-07-28T20:07:54Z
dc.date.available.none.fl_str_mv	2025-07-28T20:07:54Z
dc.date.issued.none.fl_str_mv	2025-07
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dc.type.local.spa.fl_str_mv	Tesis/Trabajo de grado - Monografía - Especialización
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dc.identifier.uri.none.fl_str_mv	https://hdl.handle.net/20.500.12495/15388
dc.identifier.instname.spa.fl_str_mv	instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv	reponame:Repositorio Institucional Universidad El Bosque
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url	https://hdl.handle.net/20.500.12495/15388
identifier_str_mv	instname:Universidad El Bosque reponame:Repositorio Institucional Universidad El Bosque repourl:https://repositorio.unbosque.edu.co
dc.language.iso.fl_str_mv	eng
language	eng
dc.relation.references.none.fl_str_mv	1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. Vol. 76, Journal of the American College of Cardiology. 2020. 2. Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, et al. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data from the American Heart Association. Circulation. 2024;149(8). 3. Tamis-Holland JE, Jneid H, Reynolds HR, Agewall S, Brilakis ES, Brown TM, et al. Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association. Circulation. 2019;139(18). 4. Agewall S, Beltrame JF, Reynolds HR, Niessner A, Rosano G, Caforio ALP, et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. Vol. 38, European Heart Journal. 2017. 5. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618–51. 6. Abdu FA, Mohammed AQ, Liu L, Xu Y, Che W. Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): A Review of the Current Position. Vol. 145, Cardiology (Switzerland). S. Karger AG; 2020. p. 543–52. 7. Posit team. RStudio: Integrated Development Environment for R. Posit Software. Boston, MA; 2024. 8. Pasupathy S, Air T, Dreyer RP, Tavella R, Beltrame JF. Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries. Vol. 131, Circulation. Lippincott Williams and Wilkins; 2015. p. 861–70. 9. Smilowitz NR, Mahajan AM, Roe MT, Hellkamp AS, Chiswell K, Gulati M, et al. Mortality of Myocardial Infarction by Sex, Age, and Obstructive Coronary Artery Disease Status in the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines). Circ Cardiovasc Qual Outcomes. 2017;10(12). 10. Dibra L, Zaimi ; G, Pavli ; E, Gjergo ; H, Gjana ; A, Kristo ; A, et al. MINOCA, experience of a single tertiary center with a high volume of ACS. [cited 2025 Jun 30]; Available from: https://academic.oup.com/ehjacc/article/13/Supplement_1/zuae036.158/7666471 11. Haertel F, Montag C, Kraeplin T, Lauer B, Memisevic N, Moebius-Winkler S, et al. Management of myocardial infarction with non-obstructive coronary arteries (MINOCA) in Germany: a single-center study on hospital resources and healthcare economics. Front Public Health. 2024;12. 12. Dibra L, Zaimi ; G, Pavli ; E, Gjergo ; H, Gjana ; A, Kristo ; A, et al. MINOCA, experience of a single tertiary center with a high volume of ACS. [cited 2025 Jun 10]; Available from: https://academic.oup.com/ehjacc/article/13/Supplement_1/zuae036.158/7666471 13. Curtis E, To A, Meier S, Yu C, Sun D, Trieu J, et al. 317 Diagnostic Utility and Safety of Stress MRI in Patients with LV Dysfunction Diagnostic Utility of Cardiac Magnetic Resonance (CMRI) in Patients with Myocardial Infarction without Obstructive Coronary Arteries (MINOCA). Heart Lung Circ [Internet]. 2020 [cited 2025 Jun 30];29:S176. Available from: https://doi.org/10.1016/j.hlc.2020.09.324 14. Gonzalez S, Morante B;, Rodriguez PC;, Gigante PL;, De ME;, Porras C, et al. 7-Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA). 15. Kacmaz M, Schlettert C, Kreimer F, Abumayyaleh M, Akin I, Mügge A, et al. Ejection Fraction-Related Differences of Baseline Characteristics and Outcomes in Troponin-Positive Patients without Obstructive Coronary Artery Disease. J Clin Med. 2024 May 1;13(10). 16. Inci S, Gul M, Elcik D, Aktas H, Yildirim O, Kelesoglu S, et al. Identification of subclinical myocardial dysfunction by Speckle Tracking Imaging in patients with myocardial infarction with non-occlusive coronary arteries (MINOCA). International Journal of Cardiovascular Imaging. 2022 Oct 1;38(10):2099–106. 17. Tornvall P, Gerbaud E, Behaghel A, Chopard R, Collste O, Laraudogoitia E, et al. Myocarditis or “true” infarction by cardiac magnetic resonance in patients with a clinical diagnosis of myocardial infarction without obstructive coronary disease: A meta-analysis of individual patient data. Atherosclerosis. 2015;241(1). 18. Ghadri JR, Cammann VL, Napp LC, Jurisic S, Diekmann J, Bataiosu DR, et al. Differences in the clinical profile and outcomes of typical and atypical takotsubo syndrome: Data from the international takotsubo registry. JAMA Cardiol. 2016 Jun 1;1(3):335–40. 19. Bernardo M, Rocha Carvalho P, Carvalho C, Moreira I, Magalhaes P, Goncalves F, et al. Recovery of left ventricular ejection fraction in Takotsubo Syndrome [Internet]. Available from: https://academic.oup.com/eurheartj/article/44/Supplement_2/ehad655.1568/7393659 20. Ibanez B, Aletras AH, Arai AE, Arheden H, Bax J, Berry C, et al. Cardiac MRI Endpoints in Myocardial Infarction Experimental and Clinical Trials: JACC Scientific Expert Panel. 21. Bozkurt B, Colvin M, Cook J, Cooper LT, Deswal A, Fonarow GC, et al. Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement from the American Heart Association. Vol. 134, Circulation. Lippincott Williams and Wilkins; 2016. p. e579–646. 22. Pelliccia F, Pasceri V, Niccoli G, Tanzilli G, Speciale G, Gaudio C, et al. Predictors of Long-term Mortality in Patients with Myocardial Infarction and Nonobstructed Coronary Arteries: A Systematic Review and Meta-regression Study. Am J Med [Internet]. 2019 [cited 2025 Feb 9];133:73–83. Available from: https://doi.org/10.1016/j.amjmed.2019.05.048
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spelling	Carvajal Tascon, Carlos AndresGasca Zuluaga, Daniel AndresRodriguez Pulido, Astrid LorenaGasca Zuluaga, Daniel Andres [0000-0003-0357-6796]2025-07-28T20:07:54Z2025-07-28T20:07:54Z2025-07https://hdl.handle.net/20.500.12495/15388instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coObjetivos: Evaluar el impacto de la resonancia magnética cardíaca en el diagnóstico, manejo terapéutico y pronóstico de pacientes con infarto agudo de miocardio y aterosclerosis coronaria no obstructiva (MINOCA). Métodos: Estudio de cohorte ambispectivo que incluyó a 78 participantes diagnosticados con MINOCA entre 2019 y 2024, sometidos a resonancia magnética cardíaca. Se excluyeron pacientes con enfermedad coronaria conocida o intervenida previamente, así como con cardiomiopatías hipertróficas o infiltrativas. El desenlace primario fue la aparición de eventos cardiovasculares adversos mayores (MACE) durante un seguimiento de 12 meses. Resultados: La comorbilidad más frecuente fue dislipidemia (45%). La resonancia magnética permitió clasificar etiologías en la mayoría de los casos, destacando la miocarditis (41%) como la más frecuente. La fracción de eyección del ventrículo izquierdo (FEVI) fue significativamente menor en pacientes con Takotsubo. El realce tardío fue más común en miocarditis (78%), con distribución predominantemente subepicárdica y mesocardia. La resonancia modificó el manejo terapéutico en altos porcentajes: Takotsubo (100%), IAM tipo 2 (79%), miocarditis (75%), lesión miocárdica (80%) e INOCA (45%). Los eventos MACE ocurrieron exclusivamente en pacientes con INOCA (18%; p=0.0522), incluyendo un caso de accidente cerebrovascular/infarto (4.5%) y tres hospitalizaciones por causas cardiovasculares (14%). Conclusiones: La resonancia magnética cardíaca fue una herramienta diagnóstica fundamental en pacientes con MINOCA, permitiendo una reclasificación etiológica precisa en la mayoría de los casos y facilitando ajustes terapéuticos en un rango entre el 75% y 100%. La baja incidencia de eventos adversos y la ausencia de mortalidad en el seguimiento sugieren un pronóstico favorable a corto plazo en esta cohorte.Fundacion Santa Fe de BogotaEspecialista en Cardiología de AdultosEspecializaciónObjectives: To evaluate the impact of cardiac magnetic resonance on the diagnosis, therapeutic management, and prognosis of patients with acute myocardial infarction and non-obstructive coronary artery disease (MINOCA). Methods: Ambispective cohort study that included 78 participants diagnosed with MINOCA between 2019 and 2024, who underwent cardiac magnetic resonance. Patients with known or previously intervened coronary artery disease, as well as with hypertrophic or infiltrative cardiomyopathies, were excluded. The primary outcome was the occurrence of major adverse cardiovascular events (MACE) during a 12-month follow-up. Results: The most frequent comorbidity was dyslipidemia (45%). Magnetic resonance allowed the classification of etiologies in most cases, highlighting myocarditis (41%) as the most frequent. The left ventricular ejection fraction (LVEF) was significantly lower in patients with Takotsubo. Late gadolinium enhancement was more common in myocarditis (78%), with predominantly subepicardial and mesocardial distribution. Magnetic resonance modified therapeutic management in high percentages: Takotsubo (100%), type 2 AMI (79%), myocarditis (75%), myocardial injury (80%), and INOCA (45%). MACE events occurred exclusively in patients with INOCA (18%; p=0.0522), including one case of cerebrovascular accident/infarction (4.5%) and three hospitalizations due to cardiovascular causes (14%). Conclusions: Cardiac magnetic resonance was a fundamental diagnostic tool in patients with MINOCA, allowing a precise etiological reclassification in most cases and facilitating therapeutic adjustments in a range between 75% and 100%. The low incidence of adverse events and the absence of mortality during follow-up suggest a favorable short-term prognosis in this cohort.application/pdfAttribution-NonCommercial-ShareAlike 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-sa/4.0/Acceso abiertohttps://purl.org/coar/access_right/c_abf2http://purl.org/coar/access_right/c_abf2Infarto agudo de miocardioEnfermedad coronariaInfarto agudo de miocardio con ateroesclerosis coronaria no obstructivaMiocarditisCardiomiopatia de TakotsuboEvento cardiovascular adverso mayorResonancia magnetica nuclearMyocardial InfarctionCoronary Artery DiseaseMyocardial Infarction and Non-obstructed Coronary ArteriesMyocarditisTakotsubo CardiomyopathyMajor Adverse Cardiovascular EventsTherapeutic ManagementMagnetic Resonance ImagingWG 100Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)Impact of cardiac magnetic resonance on the diagnosis, treatment, and outcomes of patients with acute myocardial infarction with non-obstructive coronary artery disease (MINOCA)Especialización en Cardiología AdultosUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. Roth GA, Mensah GA, Johnson CO, Addolorato G, Ammirati E, Baddour LM, et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study. Vol. 76, Journal of the American College of Cardiology. 2020.2. Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, et al. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data from the American Heart Association. Circulation. 2024;149(8).3. Tamis-Holland JE, Jneid H, Reynolds HR, Agewall S, Brilakis ES, Brown TM, et al. Contemporary Diagnosis and Management of Patients With Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement From the American Heart Association. Circulation. 2019;139(18).4. Agewall S, Beltrame JF, Reynolds HR, Niessner A, Rosano G, Caforio ALP, et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. Vol. 38, European Heart Journal. 2017.5. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). Circulation. 2018 Nov 13;138(20):e618–51.6. Abdu FA, Mohammed AQ, Liu L, Xu Y, Che W. Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): A Review of the Current Position. Vol. 145, Cardiology (Switzerland). S. Karger AG; 2020. p. 543–52.7. Posit team. RStudio: Integrated Development Environment for R. Posit Software. Boston, MA; 2024.8. Pasupathy S, Air T, Dreyer RP, Tavella R, Beltrame JF. Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries. Vol. 131, Circulation. Lippincott Williams and Wilkins; 2015. p. 861–70.9. Smilowitz NR, Mahajan AM, Roe MT, Hellkamp AS, Chiswell K, Gulati M, et al. Mortality of Myocardial Infarction by Sex, Age, and Obstructive Coronary Artery Disease Status in the ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry-Get with the Guidelines). Circ Cardiovasc Qual Outcomes. 2017;10(12).10. Dibra L, Zaimi ; G, Pavli ; E, Gjergo ; H, Gjana ; A, Kristo ; A, et al. MINOCA, experience of a single tertiary center with a high volume of ACS. [cited 2025 Jun 30]; Available from: https://academic.oup.com/ehjacc/article/13/Supplement_1/zuae036.158/766647111. Haertel F, Montag C, Kraeplin T, Lauer B, Memisevic N, Moebius-Winkler S, et al. Management of myocardial infarction with non-obstructive coronary arteries (MINOCA) in Germany: a single-center study on hospital resources and healthcare economics. Front Public Health. 2024;12.12. Dibra L, Zaimi ; G, Pavli ; E, Gjergo ; H, Gjana ; A, Kristo ; A, et al. MINOCA, experience of a single tertiary center with a high volume of ACS. 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Impacto de la resonancia magnética cardíaca en el diagnóstico, tratamiento y desenlaces del paciente con infarto agudo de miocardio con ateroesclerosis coronaria no obstructiva (MINOCA)

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