MINOCA: A Pathophysiological Approach of Diagnosis and Treatment-A Narrative Review

被引：1

作者：

Khattab, Elina ^{[1
]}

Karelas, Dimitrios ^{[2
]}

Pallas, Theofilos ^{[3
]}

Kostakis, Panagiotis ^{[4
]}

Papadopoulos, Constantinos H. ^{[2
]}

Sideris, Skevos ^{[4
]}

Patsourakos, Nikolaos ^{[3
]}

Kadoglou, Nikolaos P. E. ^{[1
]}

机构：

[1] Univ Cyprus, Med Sch, CY-2029 Nicosia, Cyprus

[2] Korgialenio Benakio Red Cross Hosp, Cardiol Dept 2, Athens 11526, Greece

[3] Tzaneio Gen Hosp Piraeus, Dept Cardiol, Piraeus 18536, Greece

[4] Hippokrateion Hosp, Dept Cardiol, Athens 11527, Greece

来源：

BIOMEDICINES | 2024年 / 12卷 / 11期

关键词：

myocardial infarction with non-obstructive coronary arteries; thromboembolism; coronary artery spasm; spontaneous coronary artery dissection; coronary microvascular disease; diagnosis; prognosis; ACUTE MYOCARDIAL-INFARCTION; NONOBSTRUCTIVE CORONARY-ARTERIES; CLINICAL-OUTCOMES; POSITION PAPER; CHEST-PAIN; DISEASE; ASSOCIATION; PROGNOSIS; MECHANISMS; MANAGEMENT;

D O I：

10.3390/biomedicines12112457

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

071010 ; 081704 ;

摘要：

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a clinical entity characterized by the absence of significant coronary artery obstruction in epicardial arteries (<50%) on coronary angiography in the setting of acute myocardial infarction (AMI). This article aims to provide a narrative review of the pathophysiological mechanisms, diagnostic challenges, and prognosis associated with MINOCA based on pathophysiology regarding the atherosclerotic and non-atherosclerotic causes. Etiological factors, including thromboembolism, coronary artery spasm, spontaneous coronary artery dissection, coronary microvascular disease, and supply-demand mismatch, are addressed. Imaging modalities such as echocardiography, advances in coronary angiography like intravascular ultrasound (IVUS) and optical coherence tomography (OCT), cardiac magnetic resonance (CMR), and coronary computed tomography angiography (CCTA) are also analyzed. MINOCA patients have a better short-term prognosis compared to those with obstructive coronary artery disease but face significant long-term risks, underscoring the need for precise diagnosis and management strategies. Elevated inflammatory markers and specific genetic predispositions are also associated with adverse outcomes in MINOCA. This review focused on MINOCA from a pathophysiological perspective on the diverse underlying mechanisms, the challenges in achieving accurate diagnosis, the importance of a tailored therapeutic approach and the necessity for further investigation of clinical outcomes.

引用

页数：23