Key result
Comprehensive testing identifies the cause of MINOCA in most cases, enabling tailored secondary prevention.
Why the study?
Determining the underlying cause of MINOCA has notable implications for tailoring secondary prevention measures to improve AMI prognosis, and establishing the cause is possible in most cases.
Appropriate diagnostic pathways can identify the underlying cause of MINOCA in most patients, which is essential for tailoring secondary prevention.
Answers are grounded in this paper and cite their sources.
Supports diagnostic evaluation in MINOCA; leaves open randomized trials on outcome impact.
When acute myocardial injury is found in a clinical setting suggestive of myocardial ischaemia, the event is labelled as acute myocardial infarction (AMI), and the absence of coronary stenosis angiographically 50% or greater leads to the working diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA). The initial diagnosis of MINOCA can be confirmed or ruled out based on the results of subsequent investigations. This narrative review discusses the downstream diagnostic approaches to MINOCA, and appraises strengths and limitations of invasive and non-invasive investigations for this condition. The aim of this article is to increase the awareness that establishing the underlying cause of a MINOCA is possible in the vast majority cases. Determining the cause of MINOCA and excluding other possible causes for cardiac troponin elevation has notable implications for tailoring secondary prevention measures aimed at improving the overall prognosis of AMI.
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Occhipinti et al. (2021) conducted a review in Myocardial infarction with non-obstructive coronary artery disease (MINOCA). Diagnostic pathways (invasive and non-invasive investigations) was evaluated. Downstream invasive and non-invasive diagnostic approaches can establish the underlying cause of MINOCA in the vast majority of cases, allowing for tailored secondary prevention measures.
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