A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries
Myocardial infarction with non-obstructive coronary arteries (MINOCA) includes coronary embolism, dissection, spasm and microvascular dysfunction, as well as plaque rupture or erosion (causing <50% stenosis). In the most recent studies, events that can be classified as MINOCA account for approxim...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2024-01-01
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| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/25/2/10.31083/j.rcm2502047 |
| _version_ | 1797291674302414848 |
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| author | Leonardo De Luca Federico Andreoli Raffaella Mistrulli Giulia Mattaroccia Gianmarco Gargano Domenico Gabrielli |
| author_facet | Leonardo De Luca Federico Andreoli Raffaella Mistrulli Giulia Mattaroccia Gianmarco Gargano Domenico Gabrielli |
| author_sort | Leonardo De Luca |
| collection | DOAJ |
| description | Myocardial infarction with non-obstructive coronary arteries (MINOCA) includes coronary embolism, dissection, spasm and microvascular dysfunction, as well as plaque rupture or erosion (causing <50% stenosis). In the most recent studies, events that can be classified as MINOCA account for approximately 6–8% of all diagnoses of acute myocardial infarction (AMI). Clinical suspect may suggest the need for additional diagnostic procedures beyond the usual coronary angiography, such as cardiac imaging or provocative tests. Cardiac magnetic resonance (CMR) is essential for both validating the diagnosis and ruling out other conditions with a comparable clinical presentation. The prognosis is not as good as previously believed; rather, it is marked by morbidity and mortality rates comparable to those of other types of AMI. Identification of the underlying causes of MINOCA is recommended by current guidelines and consensus documents in order to optimize treatment, enhance prognosis, and encourage prevention of recurrent myocardial infarction. In this narrative review, we have outlined the various causes of MINOCA and their specific therapies in an attempt to identify a personalized approach to its treatment. |
| first_indexed | 2024-03-07T19:39:45Z |
| format | Article |
| id | doaj.art-f81ffc868f9c4ae2ba00125aca07880e |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-03-07T19:39:45Z |
| publishDate | 2024-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-f81ffc868f9c4ae2ba00125aca07880e2024-02-29T06:14:30ZengIMR PressReviews in Cardiovascular Medicine1530-65502024-01-012524710.31083/j.rcm2502047S1530-6550(23)01146-8A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary ArteriesLeonardo De Luca0Federico Andreoli1Raffaella Mistrulli2Giulia Mattaroccia3Gianmarco Gargano4Domenico Gabrielli5Department of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyDepartment of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyDepartment of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyDepartment of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyDepartment of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyDepartment of Cardio-Thoracic and Vascular Medicine and Surgery, Division of Cardiology, A.O. San Camillo-Forlanini, 00152 Rome, ItalyMyocardial infarction with non-obstructive coronary arteries (MINOCA) includes coronary embolism, dissection, spasm and microvascular dysfunction, as well as plaque rupture or erosion (causing <50% stenosis). In the most recent studies, events that can be classified as MINOCA account for approximately 6–8% of all diagnoses of acute myocardial infarction (AMI). Clinical suspect may suggest the need for additional diagnostic procedures beyond the usual coronary angiography, such as cardiac imaging or provocative tests. Cardiac magnetic resonance (CMR) is essential for both validating the diagnosis and ruling out other conditions with a comparable clinical presentation. The prognosis is not as good as previously believed; rather, it is marked by morbidity and mortality rates comparable to those of other types of AMI. Identification of the underlying causes of MINOCA is recommended by current guidelines and consensus documents in order to optimize treatment, enhance prognosis, and encourage prevention of recurrent myocardial infarction. In this narrative review, we have outlined the various causes of MINOCA and their specific therapies in an attempt to identify a personalized approach to its treatment.https://www.imrpress.com/journal/RCM/25/2/10.31083/j.rcm2502047myocardial infarction with non-obstructive coronary arteriesacute coronary syndromespontaneous coronary artery dissection |
| spellingShingle | Leonardo De Luca Federico Andreoli Raffaella Mistrulli Giulia Mattaroccia Gianmarco Gargano Domenico Gabrielli A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries Reviews in Cardiovascular Medicine myocardial infarction with non-obstructive coronary arteries acute coronary syndrome spontaneous coronary artery dissection |
| title | A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries |
| title_full | A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries |
| title_fullStr | A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries |
| title_full_unstemmed | A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries |
| title_short | A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries |
| title_sort | personalized approach for patients with myocardial infarction with non obstructive coronary arteries |
| topic | myocardial infarction with non-obstructive coronary arteries acute coronary syndrome spontaneous coronary artery dissection |
| url | https://www.imrpress.com/journal/RCM/25/2/10.31083/j.rcm2502047 |
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