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Bertil Lindahl, Tomasz Baron, David Erlinge, Nermin Hadziosmanovic, Anna M Nordenskjöld, Anton Gard, Tomas Jernberg
Background -Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) occurs in 5-10% of all patients with MI. Clinical trials of secondary prevention treatment in MINOCA patients are lacking. Therefore, the aim of this study was to examine the associations between treatment with statins, renin-angiotensin system blockers, beta-blockers, dual antiplatelet therapy and long-term cardiovascular events. Methods -Observational study of MINOCA patients recorded in the SWEDEHEART registry between July 2003 and June 2013 and followed until December 2013 for outcome events in the Swedish Cause of Death Register and National Patient Register...
February 8, 2017: Circulation
Nana Poku, Stephane Noble
MINOCA is a clinical syndrome that encompasses a subgroup of heterogeneous patients who present with myocardial infarction yet do not have any significant coronary artery obstruction on angiogram. As many as one in ten patients with acute myocardial infarction (AMI) will not have an occluded coronary artery, and the reported prevalence keeps rising, in part due to better recognition of this syndrome. Current guidelines offer several diagnostic algorithms but MINOCA remains largely under-recognised and little is known about whether patients might benefit from a more specific treatment modality...
January 2017: Expert Review of Cardiovascular Therapy
Rina Mauricio, Monvadi B Srichai, Leon Axel, Judith S Hochman, Harmony R Reynolds
BACKGROUND: In a prospective study, cardiac MRI (CMR) and intravascular ultrasound were performed in women with myocardial infarction (MI) and nonobstructive coronary artery disease (MINOCA). Forty participants underwent adenosine-stress CMR (sCMR). HYPOTHESIS: Abnormal perfusion may co-localize with ischemic late gadolinium enhancement (LGE) and T2-weighted signal hyperintensity (T2+), suggesting microvascular dysfunction contributed to MI. METHODS: Qualitative perfusion analysis was performed by 2 independent readers...
October 2016: Clinical Cardiology
Masanobu Ishii, Koichi Kaikita, Koji Sato, Kenshi Yamanaga, Takashi Miyazaki, Tomonori Akasaka, Noriaki Tabata, Yuichiro Arima, Daisuke Sueta, Kenji Sakamoto, Eiichiro Yamamoto, Kenichi Tsujita, Megumi Yamamuro, Sunao Kojima, Hirofumi Soejima, Seiji Hokimoto, Kunihiko Matsui, Hisao Ogawa
BACKGROUND: Coronary spasm is one of the mechanisms of myocardial infarction with nonobstructive coronary arteries (MINOCA). The aim of this study was to investigate the effects of aspirin on future cardiovascular events in patients with coronary vasospastic angina (VSA) with non-significant atherosclerotic stenosis. METHODS: This was the retrospective analysis of the 640 VSA patients with non-significant atherosclerotic stenosis (≤50% stenosis) among 1,877 consecutive patients who underwent acetylcholine (ACh)-provocation testing between January 1991 and December 2010...
October 1, 2016: International Journal of Cardiology
Nigussie Bogale, Mathieu Lempereur, Imran Sheikh, David Wood, Jacqueline Saw, Anthony Fung
INTRODUCTION: Coronary angiography is commonly performed following non-ST segment elevation myocardial infarction (NSTEMI) to assess the need for revascularization. Some of these patients have myocardial infarction (MI) with no obstructive coronary atherosclerosis (MINOCA). Patients without severe obstructive lesions are usually treated conservatively. However, coronary angiography has known limitations in the assessment of lesion severity. We report our experience of using coronary Optical Coherence Tomography (OCT) in a series of patients without severe obstructive coronary lesions...
March 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Sivabaskari Pasupathy, Rosanna Tavella, John F Beltrame
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is an intriguing clinical entity that is being increasingly recognized with the more common use of coronary angiography during acute myocardial infarction. This review systematically addresses the contemporary understanding of MINOCA, including, (1) what are the diagnostic criteria, (2) when the diagnosis should be considered, (3) who is at risk, (4) why this new syndrome should be diagnosed, (5) how these patients should be managed, and (6) where to next?...
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Elin B Brolin, Torkel B Brismar, Olov Collste, Shams Y-Hassan, Loghman Henareh, Per Tornvall, Kerstin Cederlund
Mechanisms of acute myocardial infarction and nonobstructed coronary arteries (MINOCA) are incompletely understood. Myocardial bridging (MB) is usually considered a benign congenital variant, but serious complications have been reported. MB has also been proposed as a cause of takotsubo syndrome (TS). We aimed to examine whether MB was more frequent in patients with MINOCA or TS than in age- and gender-matched controls and to compare the MB detection rates of coronary computed tomography angiography (CTA) and invasive coronary angiography (ICA)...
December 15, 2015: American Journal of Cardiology
P Tornvall, E Gerbaud, A Behaghel, R Chopard, O Collste, E Laraudogoitia, G Leurent, N Meneveau, M Montaudon, E Perez-David, P Sörensson, S Agewall
OBJECTIVE: Myocardial Infarction with Non-Obstructed Coronary Arteries (MINOCA) is common, but the causes are to a large extent unknown. Thus, we aimed to study the prevalence of myocarditis and "true" myocardial infarction determined by cardiac magnetic resonance (CMR) imaging in MINOCA patients, and risk markers for these two conditions in this population. METHODS: A search was made in the PubMed and Cochrane databases using the search terms "Myocardial infarction", "Coronary angiography", "Normal coronary arteries" and "MRI"...
July 2015: Atherosclerosis
Sivabaskari Pasupathy, Tracy Air, Rachel P Dreyer, Rosanna Tavella, John F Beltrame
BACKGROUND: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a puzzling clinical entity with no previous evaluation of the literature. This systematic review aims to (1) quantify the prevalence, risk factors, and 12-month prognosis in patients with MINOCA, and (2) evaluate potential pathophysiological mechanisms underlying this disorder. METHODS AND RESULTS: Quantitative assessment of 28 publications using a meta-analytic approach evaluated the prevalence, clinical features, and prognosis of MINOCA...
March 10, 2015: Circulation
Giampaolo Niccoli, Giancarla Scalone, Filippo Crea
Myocardial infarction (MI) with no obstructive coronary atherosclerosis (MINOCA) is a syndrome with different causes. Its prevalence ranges between 5 and 25% of all MIs. The prognosis is extremely variable, depending on the causes of MINOCA. Clinical history, echocardiography, coronary angiography, and left ventriculography represent the first-level diagnostic investigations. Nevertheless, additional tests are required in order to establish its specific cause, thus allowing an appropriate risk stratification and treatment...
February 21, 2015: European Heart Journal
John F Beltrame
No abstract text is available yet for this article.
February 2013: Journal of Internal Medicine
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