Ciliberti Giuseppe, Bergamaschi Luca, Paolisso Pasquale, Zilio Filippo, Pizzi Carmine
Clinica di Cardiologia e Aritmologia, AOU Ospedali Riuniti Umberto I-Lancisi-Salesi, Ancona.
U.O. Cardiologia, IRCCS Azienda Ospedaliera-Universitaria di Bologna, Dipartimento di Scienze Mediche e Chirurgiche - DIMEC, Alma Mater Studiorum, Università degli Studi, Bologna.
G Ital Cardiol (Rome). 2024 Apr;25(4):229-238. doi: 10.1714/4244.42204.
The term "MINOCA" refers to myocardial infarction with non-obstructed coronary arteries and has been used to define acute myocardial infarction with no angiographic evidence of significant epicardial coronary artery stenosis. Patients with MINOCA represent a rather heterogeneous group of acute coronary syndrome, and this may account for the wide variation in the incidence of MINOCA in different studies. Several pathogenic mechanisms have been suggested to underlie MINOCA, but the condition continues to represent a diagnostic and therapeutic challenge for the cardiologist. Therefore, an adequate diagnostic assessment, carefully characterizing the pathogenic mechanisms, and a selection of more targeted treatments are needed to improve clinical outcomes. In this focused review, we will try to provide answers to the most common questions on the causes, diagnosis, treatment, and outcomes of MINOCA.
“MINOCA”一词指非阻塞性冠状动脉心肌梗死,用于定义无明显心外膜冠状动脉狭窄血管造影证据的急性心肌梗死。MINOCA患者代表了一组相当异质性的急性冠状动脉综合征,这可能解释了不同研究中MINOCA发病率的广泛差异。已经提出了几种致病机制作为MINOCA的基础,但这种情况仍然是心脏病专家面临的诊断和治疗挑战。因此,需要进行充分的诊断评估,仔细确定致病机制,并选择更有针对性的治疗方法来改善临床结果。在这篇聚焦综述中,我们将尝试回答关于MINOCA的病因、诊断、治疗和结果的最常见问题。