Ezhumalai Babu, Modi Ranjan, Chidambaram Sundar
Department of Cardiology, Apollo Speciality Hospitals Vanagaram, Chennai, India.
Department of Cardiology, Indraprastha Apollo Hospitals, New Delhi, India.
Indian Heart J. 2025 Jul-Aug;77(4):318-325. doi: 10.1016/j.ihj.2025.05.013. Epub 2025 May 29.
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is defined as clinical evidence of myocardial infarction (MI) without significant obstruction (<50 % stenosis) in coronary angiography, making it a clinically distinct and heterogeneous disorder. Unlike MI associated with obstructive coronary artery disease (MICAD), MINOCA is more common in younger women and often involves microvascular dysfunction or vasospastic conditions. Despite recent advancements in understanding MINOCA, its prognosis and predictors remain uncertain, necessitating further research into its pathogenesis. The diverse underlying causes of MINOCA mean that traditional treatment of the "one-size-fits-all" approach used for MICAD may not be appropriate, emphasizing the need for individualized treatment strategies based on accurate diagnosis. There is an urgent need to raise awareness among healthcare providers, implement standardized diagnostic protocols, and conduct targeted research to improve patient outcomes. Multi-centered studies and clinical trials are essential to establish evidence-based therapies and optimize management strategies for MINOCA, ensuring better long-term outcomes.
非阻塞性冠状动脉心肌梗死（MINOCA）被定义为冠状动脉造影显示无明显阻塞（狭窄<50%）的心肌梗死（MI）临床证据，这使其成为一种临床上独特且异质性的疾病。与伴有阻塞性冠状动脉疾病（MICAD）的心肌梗死不同，MINOCA在年轻女性中更为常见，且常涉及微血管功能障碍或血管痉挛情况。尽管最近在理解MINOCA方面取得了进展，但其预后和预测因素仍不确定，因此有必要进一步研究其发病机制。MINOCA的多种潜在病因意味着用于MICAD的“一刀切”传统治疗方法可能不合适，这强调了基于准确诊断制定个体化治疗策略的必要性。迫切需要提高医疗服务提供者的认识，实施标准化诊断方案，并开展针对性研究以改善患者预后。多中心研究和临床试验对于建立基于证据的治疗方法以及优化MINOCA的管理策略至关重要，从而实现更好的长期预后。
