Mechanisms of myocardial infarction with nonobstructive coronary atherosclerosis: a multifaceted play of different actors with guarded prognosis

Curr Opin Cardiol. 2020 Nov;35(6):697-704. doi: 10.1097/HCO.0000000000000787.

Abstract

Purpose of review: Myocardial infarction (MI) with nonobstructive coronary atherosclerosis (MINOCA) on invasive angiography (stenosis severity <50%) is a heterogenous clinical entity with a prevalence between 6 and 8% of all MI. Whereas the long-term prognosis of MINOCA is not benign, the identification of its underlying mechanism is critical for appropriate risk stratification and tailored secondary prevention strategies.

Recent findings: The current review summarizes the contemporary data on the mechanisms, diagnosis, management strategies and outcomes of MINOCA.

Summary: MINOCA is a relatively common form of MI with guarded prognosis. The use of additional diagnostic tests (particularly intracoronary imaging and cardiac magnetic resonance) is paramount to determine the exact cause of MINOCA and implement tailored medical interventions.

Publication types

  • Review

MeSH terms

  • Coronary Angiography
  • Coronary Artery Disease* / diagnosis
  • Coronary Vessels / diagnostic imaging
  • Humans
  • Myocardial Infarction* / diagnosis
  • Prognosis
  • Risk Factors