Pelliccia F, et al. – In this systematic review and meta-analysis of 44 studies representing 36,932 patients, researchers assessed the long-term mortality of patients with myocardial infarction and non-obstructed coronary arteries (MINOCA), and identified potential prognostic determinants of long-term outcomes. Twenty-six studies that contrasted patients with MINOCA with those with myocardial infarction and obstructive coronary artery disease showed that annual rates of long-term total mortality were 2.2% and 5.0%, respectively, with a marked difference between the two groups. Upon meta-regression analysis, the investigators noted that normal ejection fraction and normal coronary arteries at angiography were inversely associated with long-term mortality whereas the use of beta-blockers during follow-up and ST depression on the admission electrocardiogram were directly linked to poorer outcomes. Overall, long-term mortality following MINOCA was lower than that in patients with myocardial infarction and obstructive coronary artery disease, but it is not trivial. Reduced ejection fraction, non-obstructive coronary artery disease, use of beta-blockers during follow up and ST depression on the admission electrocardiogram were significant predictors of long-term prognosis.