TCT-788 Aspirin Alone Vs P2Y12 Inhibitor Alone vs Dual Antiplatelet Therapy Post Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): A Meta- Analysis

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: Myocardial Infarction with non-obstructive coronary arteries (MINOCA) accounts for 2-6% of all myocardial infarctions. We conducted a meta-analysis to determine the efficacy of aspirin alone (ASA) vs P2Y12 inhibitor alone vs Dual Antiplatelet therapy (DAPT) post MINOCA. Methods: A systematic literature search was conducted across multiple databases to find studies that reported outcomes for ASA, P2Y12 inhibitor alone vs DAPT post MINOCA. We performed statistical pooling for incidence estimates using the generic inverse variance method employing a random effects model. Results: A total of six studies [n=13635} were included in the meta-analysis. ASA was not associated with a reduced incidence of Major adverse cardiovascular events (MACE) [pooled HR=1.06; 95% CI=0.41-2.72, p>0.05] or Repeat MI [summary HR=1.12; 0.47-2.65]. P2Y12 inhibitor therapy alone was not associated with a reduced incidence of MACE or reduced mortality (p>0.05). DAPT therapy post MINOCA was found to be associated with reduced mortality [Summary HR=0.73; 95% CI=0.55-0.97, p<0.05] but did not with a reduced risk of MACE (p>0.05). The outcome of Repeat MI for DAPT could not be pooled due to only one study reporting this outcome. [Formula presented] Conclusion: After MINOCA, Dual Antiplatelet therapy is associated with reduced mortality and favourable outcomes. However, mono-platelet therapy does not have a mortality or MACE benefit. Large scale randomized prospective data is needed to establish conclusive evidence. Categories: CORONARY: Acute Myocardial Infarction

Volume

86

Issue

17 Supplement

First Page

B343

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