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非阻塞性冠状动脉所致心肌梗死:临床综述

Myocardial infarction with nonobstructive coronary arteries: A clinical review.

作者信息

Barnes Jonathan

机构信息

Jonathan Barnes is an adjunct professor in the PA program at California Baptist University in Riverside, Calif., and a PA fellow in advanced heart failure and transplant medicine at Mayo Clinic, Ariz. The author has disclosed no potential conflicts of interest, financial or otherwise.

出版信息

JAAPA. 2025 Mar 1;38(3):37-43. doi: 10.1097/01.JAA.0000000000000081. Epub 2025 Feb 25.

Abstract

Myocardial infarction with nonobstructive coronary arteries (MINOCA) is an important, often underrecognized working diagnosis. MINOCA is defined as an acute MI in a patient whose coronary angiography reveals no significant obstructive coronary artery disease. A comprehensive diagnostic approach beyond the initial coronary angiogram is essential for identifying this heterogeneous infarction pathophysiology. Distinguishing disease-specific causes affects patient management and prognosis, especially in female patients. This article provides an evidence-based overview of the tailored management strategies and ongoing clinical research likely to shape future guidelines.

摘要

非阻塞性冠状动脉心肌梗死(MINOCA)是一种重要但常未被充分认识的临床诊断。MINOCA被定义为冠状动脉造影显示无明显阻塞性冠状动脉疾病的患者发生的急性心肌梗死。除了初始冠状动脉造影外,采用全面的诊断方法对于识别这种异质性梗死的病理生理学至关重要。区分特定疾病的病因会影响患者的管理和预后,尤其是在女性患者中。本文基于证据概述了针对性的管理策略以及可能影响未来指南制定的正在进行的临床研究。

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