Pathophysiology of Myocardial Infarction With Nonobstructive Coronary Artery Disease: A Contemporary Systematic Review.

Autor:	Boivin-Proulx LA; Division of Cardiology, Interventional Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Haddad K; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada., Lombardi M; Hospital Clínico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain.; Department of Internal Medicine, University of Genova, Genova, Italy., Chong AY; Division of Cardiology, Interventional Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada., Escaned J; Hospital Clínico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain., Mukherjee S; Department of Cardiology, Cabrini Health, Malvern, Victoria, New South Wales, Australia., Forcillo J; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada.; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada., Potter BJ; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada.; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada., Coutinho T; Mayo Clinic, Rochester, Minnesota, USA., Pacheco C; Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada.; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada.; Hôpital Pierre-Boucher, Longueuil, Quebec, Canada.
Jazyk:	angličtina
Zdroj:	CJC open [CJC Open] 2023 Nov 18; Vol. 6 (2Part B), pp. 380-390. Date of Electronic Publication: 2023 Nov 18 (Print Publication: 2024).
DOI:	10.1016/j.cjco.2023.11.014
Abstrakt:	Background: Myocardial infarction with nonobstructive coronary artery disease (MINOCA) is defined as acute myocardial infarction (AMI) with angiographically nonobstructive coronary artery disease. MINOCA represents 6% of all AMI cases and is associated with increased mortality and morbidity. However, the wide array of pathophysiological factors and causes associated with MINOCA presents a diagnostic conundrum. Therefore, we conducted a contemporary systematic review of the pathophysiology of MINOCA. Methods: A comprehensive systematic review of MINOCA was carried out through the utilization of the PubMed database. All systematic reviews, meta-analyses, randomized controlled trials, and cohort studies available in English or French that reported on the pathophysiology of MINOCA published after January 1, 2013 were retained. Results: Of the 600 identified records, 80 records were retained. Central to the concept of MINOCA is the definition of AMI, characterized by the presence of myocardial damage reflected by elevated cardiac biomarkers in the setting of acute myocardial ischemia. As a result, a structured approach should be adopted to thoroughly assess and address clinically overlooked obstructive coronary artery disease, and cardiac and extracardiac mechanisms of myocyte injury. Once these options have been ruled out, a diagnosis of MINOCA can be established, and the appropriate multimodal assessment can be conducted to determine its specific underlying cause (plaque disruption, epicardial coronary vasospasm, coronary microvascular dysfunction, and coronary embolism and/or spontaneous coronary dissection or supply-demand mismatch). Conclusions: Integrating a suitable definition of AMI and understanding the pathophysiological mechanisms of MINOCA are crucial to ensure an effective multimodal diagnostic evaluation and the provision of adequate tailored therapies. (© 2023 The Authors.)
Databáze:	MEDLINE
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