Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): A Review of the Current Position

Cardiology. 2020;145(9):543-552. doi: 10.1159/000509100. Epub 2020 Aug 4.

Abstract

Myocardial infarction with nonobstructive coronary arteries (MINOCA) remains a puzzling clinical entity that is characterized by clinical evidence of myocardial infarction (MI) with normal or near-normal coronary arteries on angiography (stenosis <50%). Major advances in understanding this condition have been made in recent years. The precise pathogenesis is poorly understood and is being studied and examined further. Guidelines indicate that MINOCA is a group of heterogeneous diseases with different mechanisms of pathology. Since there are multiple possible pathological mechanisms, it is not certain that the classical secondary prevention and treatment strategy for MI with obstructive coronary artery disease (MI-CAD) is optimal for MINOCA patients. The prognosis and predictors for MINOCA patients remain unclear. Although the prognosis is slightly better for MINOCA patients than for MI-CAD patients, MINOCA isn't always benign. The aim of this paper was to review the literature and evaluate MINOCA epidemiology, clinical features, etiology, diagnosis, treatment, and prognosis.

Keywords: Clinical features; Etiology; MINOCA; Management; Predictors; Prevalence; Prognosis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / epidemiology*
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / therapy
  • Humans
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / epidemiology*
  • Myocardial Infarction / etiology
  • Myocardial Infarction / therapy
  • Prognosis
  • Risk Factors