{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T14:34:25Z","timestamp":1745850865429,"version":"3.40.3"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Sex differences in ST\u2010segment elevation myocardial infarction (STEMI) due to obstructive coronary artery disease (CAD) are well\u2010established, but limited research exists on sex differences in STEMI patients with nonobstructive coronary arteries (MINOCA) and MINOCA mimickers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 8560 consecutive STEMI patients, enrolled in the Midwest STEMI Consortium from 2003 to 2020. Patients with non\u2010obstructive CAD were classified into MINOCA (defined as &lt;\u200950% coronary artery stenosis and confirmed or suspected coronary artery plaque disruption, epicardial coronary spasm, or coronary embolism\/thrombosis) and MINOCA mimickers (takotsubo cardiomyopathy, myocarditis, or non\u2010ischemic cardiomyopathy). The primary outcome was 5\u2010year all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 8560 patients, 409 (4.8%) had non\u2010obstructive CAD, including 120 (1.4%) MINOCA and 289 (3.4%) MINOCA mimickers. Females were more likely to have MINOCA and MINOCA mimickers (49.2% and 56.4%, respectively). There were no significant sex differences in in\u2010hospital or 5\u2010year mortality in MINOCA, but females with MINOCA mimickers had higher unadjusted 5\u2010year mortality (HR 2.90, 95% CI 1.53\u22125.53). After adjusting for age and comorbidities, the long\u2010term mortality risk was similar between sexes (adjusted HR 1.16, 95% CI: 0.61\u22122.24). Females with obstructive CAD had higher 5\u2010year mortality in unadjusted models (HR 1.66, 95% CI 1.48, 1.86), but the difference was not significant after adjustment (adjusted HR 1.1, 95% CI: 0.98\u22121.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings highlight important sex\u2010based differences in the prevalence, treatment, and long\u2010term outcomes of STEMI patients with MINOCA, MINOCA mimickers, and obstructive CAD. Despite clinical disparities, mortality risks were similar across sexes after adjusting for comorbidities.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31438","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T09:55:31Z","timestamp":1738749331000},"page":"1204-1213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Sex Differences in Patients Presenting With ST\u2010Segment Elevation Myocardial Infarction and Nonobstructive Coronary Arteries"],"prefix":"10.1002","volume":"105","author":[{"given":"Mehmet","family":"Yildiz","sequence":"first","affiliation":[{"name":"The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital Cincinnati Ohio USA"},{"name":"Women's Heart Center, The Christ Hospital Heart and Vascular Institute Cincinnati Ohio 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