Key result
MINOCA carries ~3-point lower annual mortality than obstructive CAD, though long-term risk persists.
Why the study?
MINOCA is a clinically relevant condition whose pathophysiological mechanisms and possible etiologies require study due to their impact on patient morbidity and mortality.
Systematic Review
This systematic review aims to summarize the clinical profile, pathophysiology, and etiologies of MINOCA.
Answers are grounded in this paper and cite their sources.
MINOCA warrants targeted evaluation despite lower mortality than obstructive CAD; confirms differential prognosis and extends evidence for etiology-specific strategies.
Background: Acute myocardial infarction (AMI) without obstructive coronary arteries (MINOCA) is a medical condition of great relevance, with clinical characteristics of AMI, but without evidence of coronary artery obstruction. The mechanism involved in the pathophysiology of the disease and its possible etiologies are important objects of study due to their impact on the morbidity and mortality of affected patients. Objectives : The aim of this study was to systematically review MINOCA and its characteristics, with emphasis on the clinical profile of patients, etiology, pathophysiology, diagnosis, and treatment of the syndrome. Methods : Relevant articles related to MINOCA were analyzed in the PubMed and LILACS databases. In the initial search stage, 619 eligible articles were obtained, with final inclusion criteria being: original systematic reviews with clinical, epidemiological, diagnostic, or treatment data on MINOCA, published in Portuguese or English, with an abstract, and a publication date limit of September 2020. Results : A total of 10 articles classified as systematic reviews that considered clinical data on MINOCA were included in this review. Conclusion : After analyzing various literature, the present study provided a tool to better understand MINOCA, not only regarding its casuistry but also in grouping parameters and information that contribute to a healthy approach to this clinical situation. It was possible to identify and better outline the clinical profile of patients who presented this condition and the use of appropriate tools for correct diagnosis and ideal treatment.
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Oliveira et al. (2023) conducted a systematic review in Acute Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA). Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA) vs. Myocardial infarction with obstructive coronary artery disease (MI-CAD) was evaluated. Patients with MINOCA have lower annual mortality rates than those with obstructive coronary artery disease (2.2% vs 5.0%), but still face significant long-term risks requiring targeted evaluation.
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