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Six percent to 15% of myocardial infarctions (MIs) are not associated with obstructive coronary disease on angiography (i.e., <50% stenosis in all major arteries); such myocardial infarction with nonobstructive coronary arteries (MINOCA) occurs more commonly in women. What is the mechanism of MINOCA? In this multinational study, investigators enrolled 170 women with MINOCA who were slated to undergo cardiac magnetic resonance imaging (MRI) and coronary optical coherence tomography (OCT; OCT involves use of infrared light to acquire cross-sectional images of the coronary artery via an intravascular catheter; OCT has higher resolution than intravascular ultrasound.) .
In 145 women with adequate OCT images, 67 had a possible or definite culprit…