Chen Wenjie, Jiang Yufeng, Chen Tan, Zhou Yafeng
Department of Cardiology, Dushu Lake Hospital Affiliated to Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, Jiangsu, China.
Institute for Hypertension of Soochow University, Suzhou, Jiangsu, China.
Front Cardiovasc Med. 2023 Jan 9;9:1081934. doi: 10.3389/fcvm.2022.1081934. eCollection 2022.
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous group of diseases with different pathological mechanisms, and it is uncertain whether the classical secondary prevention and treatment strategies for myocardial infarction in obstructive coronary artery disease (MI-CAD) are appropriate for patients with MINOCA. Therefore the choice of antiplatelet agents and the therapeutic effect may vary depending on the etiology and pathophysiological mechanisms of MINOCA. This requires our clinical and scientific researchers to properly design prospective studies to explore the pathophysiology of MINOCA and its corresponding etiology in greater depth, so as to understand the effectiveness and safety of medical therapies for different etiologies of MINOCA. Although the current observational studies do not show an obvious beneficial effect of antiplatelet therapy on MINOCA. We are eager to conduct specific prospective randomized controlled trials of antiplatelet agents to assess the specificity, efficacy and safety of different types of antiplatelet agents in patients with MINOCA of different etiologies.
非阻塞性冠状动脉心肌梗死（MINOCA）是一组具有不同病理机制的异质性疾病，目前尚不确定阻塞性冠状动脉疾病（MI-CAD）中经典的心肌梗死二级预防和治疗策略是否适用于MINOCA患者。因此，抗血小板药物的选择及其治疗效果可能因MINOCA的病因和病理生理机制而异。这就要求我们的临床和科研人员合理设计前瞻性研究，更深入地探索MINOCA的病理生理学及其相应病因，从而了解针对MINOCA不同病因的药物治疗的有效性和安全性。尽管目前的观察性研究未显示抗血小板治疗对MINOCA有明显有益作用。但我们迫切希望开展抗血小板药物的特定前瞻性随机对照试验，以评估不同类型抗血小板药物在不同病因MINOCA患者中的特异性、疗效和安全性。
