Women's Heart Attack Research Program- Imaging Study

Women's HARP is a multi-center, observational study which enrolls women with MI who are
referred for cardiac catheterization. Eligible participants with MINOCA (defined as no
stenosis of >50% in any major epicardial vessel) will undergo optical coherence tomography
(OCT) at the time of diagnostic angiography and cardiac magnetic resonance imaging (CMR).

Participants will also have the option to enroll in the HARP- Stress Ancillary Study and
HARP-Platelet Sub-Study.

Inclusion Criteria:

- Acute ischemic symptoms compatible with diagnosis of MI, such as chest pain or anginal
equivalent symptoms at rest or new onset exertional anginal equivalent symptoms

- Objective evidence of MI (either or both of the following):

- Elevation of troponin to above the laboratory upper limit of normal

- ST segment elevation of ≥1mm on 2 contiguous ECG leads

- Willing to provide informed consent and comply with all aspects of the protocol

- Age ≥ 21 years

- Female sex

Exclusion Criteria:

- Stenosis ≥50% of any major epicardial vessel on invasive angiography, as determined by
the angiographer at the time of clinically ordered cardiac catheterization

- History of known obstructive coronary artery disease at angiography, including history
of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG)

- Recent use of vasospastic agents, such as cocaine, triptans, or ergot alkaloids (≤1
month)

- Alternate explanation for troponin elevation, such as hypertensive urgency, acute
exacerbation of heart failure, chronic elevation due to kidney disease, pulmonary
embolism, cardiac trauma

- Coronary dissection apparent on angiography

- Excessive coronary tortuosity which, in the angiographer's opinion, increases the
risks of OCT

- eGFR<45 or contraindication to additional contrast needed for OCT in the opinion of
the angiographer or treating physician

- Contraindication to MRI (including but not limited to ferromagnetic implants)

- Pregnancy

- Thrombolytic therapy for STEMI (qualifying event)