抗血小板治疗在心肌梗死合并非阻塞性冠状动脉疾病患者中的作用

The Role of Antiplatelet Therapy in Patients With MINOCA.

作者信息

Ortega-Paz Luis, Galli Mattia, Capodanno Davide, Brugaletta Salvatore, Angiolillo Dominick J

机构信息

Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States.

Cardiovascular Institute, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.

出版信息

Front Cardiovasc Med. 2022 Feb 14;8:821297. doi: 10.3389/fcvm.2021.821297. eCollection 2021.

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous group of clinical entities characterized by the common clinical evidence of myocardial infarction (MI) with non-obstructive coronary arteries on coronary angiography and without an overt cause for the MI. Platelets play a cornerstone role in the pathophysiology of MI with obstructive coronary arteries. Accordingly, antiplatelet therapy is recommended for treating patients with MI and obstructive coronary disease. However, the role of platelets in the pathophysiology of MINOCA patients is not fully defined, questioning the role of antiplatelet therapy in this setting. In this review, we will assess the role of antiplatelet therapy in MINOCA with a focus on the pathophysiology, therapeutic targets, current evidence, and future directions according to its different etiologies.

非阻塞性冠状动脉心肌梗死（MINOCA）是一组异质性临床病症，其共同临床特征为冠状动脉造影显示非阻塞性冠状动脉且无明显心肌梗死（MI）病因的情况下出现心肌梗死的临床证据。血小板在阻塞性冠状动脉心肌梗死的病理生理学中起基石作用。因此，推荐抗血小板治疗用于治疗心肌梗死和阻塞性冠状动脉疾病患者。然而，血小板在MINOCA患者病理生理学中的作用尚未完全明确，这对这种情况下抗血小板治疗的作用提出了质疑。在本综述中，我们将根据其不同病因，评估抗血小板治疗在MINOCA中的作用，重点关注病理生理学、治疗靶点、当前证据和未来方向。