MINOCA

Myocardial infarction in the absence of obstructive coronary artery disease. CORONARY CIRCULATION disruption is due to various other factors such as ATHEROSCLEROTIC PLAQUE and CORONARY VASOSPASM.

Also Known As:

Myocardial Infarction and Non obstructed Coronary Arteries; Myocardial Infarction with Non obstructive Coronary Arteries; Myocardial Infarction and Non-obstructed Coronary Arteries; Myocardial Infarction and Nonobstructed Coronary Arteries; Myocardial Infarction with Non-obstructive Coronary Arteries; Myocardial Infarction with Nonobstructive Coronary Arteries

Networked: 175 relevant articles (6 outcomes, 26 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Myocardial Infarction
2.	Coronary Artery Disease (Coronary Atherosclerosis)
3.	Myocarditis (Carditis)
4.	Neoplasms (Cancer)
5.	Inflammation (Inflammations)

Experts

1.	Gao, Side: 9 articles (01/2022 - 01/2021)
2.	Yu, Mengyue: 9 articles (01/2022 - 01/2021)
3.	Lindahl, Bertil: 9 articles (07/2021 - 04/2017)
4.	Niccoli, Giampaolo: 8 articles (12/2022 - 02/2015)
5.	Abdu, Fuad A: 8 articles (01/2022 - 01/2019)
6.	Che, Wenliang: 8 articles (01/2022 - 01/2019)
7.	Liu, Lu: 8 articles (01/2022 - 01/2019)
8.	Ma, Wenjian: 8 articles (01/2022 - 01/2021)
9.	Tornvall, Per: 8 articles (01/2022 - 01/2018)
10.	Huang, Sizhuang: 8 articles (12/2021 - 01/2021)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to MINOCA:

1.	omega-Chloroacetophenone (Mace)IBA 01/01/2020 - "A long-term exercise-based CR program was associated with superior physical health and a significant reduction in all-cause mortality and MACE in patients with MINOCA." 01/01/2021 - "This study aimed to investigate whether the GRACE risk score is capable of predicting MACE in MINOCA patients with NSTE. " 08/01/2023 - "Pooled analysis showed that the risk of MACE was higher in MIOCA patients (risk ratio (RR): 1.47, 95%CI: 1.43-1.52, p-value: 0.001) compared to MINOCA patients. " 07/10/2023 - "During follow-up, MACE occurred significantly more frequently in MINOCA LGE+/M+ than in the LGE+/M- and normal-CMR (LGE-/M-) subgroups (20.7% vs 6.7% and 2.7%; P = 0.006). " 06/01/2023 - "The clinical prevalence rate of MINOCA at Peninsula Health is 10.9% with a MACE of 5.2%. "
2.	Hydroxymethylglutaryl-CoA Reductase Inhibitors (HMG-CoA Reductase Inhibitors)IBA 01/01/2019 - "Use of renin-angiotensin system blockers and statins was associated with lower mortality in patients with MINOCA ." 01/01/2019 - "In a multivariate model, several significant predictors of all-cause death of MINOCA were found, including the nonuse of renin-angiotensin system blockers ( HR , 2.63; 95% CI , 1.08-6.25; P=0.033) and statins ( HR , 2.17; 95% CI , 1.04-4.54; P=0.039). " 08/01/2022 - "Six observational studies of statin therapy on MINOCA, involving a total of 11,171 patients, were identified and considered eligible for analysis (9129 subjects received statin therapy while 2042 patients were part of the respective control arms). " 01/01/2021 - "Use of antiplatelets (78% [37/45] vs 95% [52/55]; P=.01), beta blockers (56% [25/45] vs 82% [45/55]; P=.004), and statins (64% [29/45] vs 85% [47/55]; P=.01) was significantly lower in patients with true MINOCA with normal CMR imaging compared with those with CMR-confirmed myocardial infarction. " 11/02/2023 - "For example, if MINOCA is attributed to plaque disruption with or without plaque thrombus formation, the fundamental treatments may include statins, agents that modulate the renin-angiotensin system (RAS), and antiplatelet therapies. "
3.	Calcium Channel Blockers (Blockers, Calcium Channel)IBA 02/01/2021 - "This report presents a case of myocardial infarction with nonobstructive coronary arteries potentially complicated with VSA that demonstrated reduction of inflammation after symptom improvement with calcium channel-blocker treatment as assessed by serial examination of pericoronary adipose tissue attenuation. " 01/01/2020 - "Therefore, with confirmed AMI and the absence of significant coronary stenosis simultaneously, MINOCA was diagnosed with the prescription of dual-antiplatelet, statins, beta-blocker, angiotensin receptors antagonist, calcium channel blocker and nitrate. "
4.	Hemoglobins (Hemoglobin)IBA 01/01/2022 - "Active cancer (HR 3.12, 95% CI 2.41-4.04) was independently associated with higher long-term mortality, while higher hemoglobin levels (HR 0.93, 95% CI 0.88-0.99, per g/dl) and a MINOCA diagnosis (HR 0.69, 95% CI 0.47-0.97) improved long-term survival. " 01/01/2022 - "The troponin T/hemoglobin ratio was higher in both cancer MINOCA and MI-CAD groups when compared with their respective non-cancer patients (both p < 0.05). "
5.	2'- deoxythymidylyl- (3'- 5')- 2'- deoxyadenosine (d(AT))IBA 11/01/2021 - "Further randomised trials evaluating the effects of potent DAPT in patients with MINOCA are warranted. " 12/01/2020 - "This study aims to identify the cases in which DAPT is currently prescribed at discharge for MINOCA. " 12/01/2020 - "In this nationwide registry, DAPT was prescribed at discharge in 55% of MINOCA patients. " 12/01/2020 - "390 (55.0%) of MINOCA patients were discharged on DAPT. " 01/01/2022 - "Dual antiplatelet therapy (DAPT) was more likely to be prescribed to STE-MINOCA patients (P = 0.015). "
6.	TroponinIBA 10/01/2022 - "The diagnosis of MINOCA should prompt further investigation to determine the underlying cause of troponin elevation. " 01/01/2021 - "MINOCA was confirmed based on significant elevated cardiac troponin and normal coronary arteries. " 12/01/2020 - "Therefore, with regards to this specific context of MINOCA, the generic term for MINOCA should be replaced with troponin-positive with non-obstructive coronary arteries (TpNOCA). " 12/01/2020 - "Troponin-Positive Non-Obstructive Coronary Arteries and Myocardial Infarction with Non-Obstructive Coronary Arteries: Definition, Etiologies, and Role of CT and MR Imaging." 10/09/2021 - "Determining the mechanism 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 acute MI. "
7.	Angiotensin-Converting Enzyme Inhibitors (ACE Inhibitors)IBA 01/01/2021 - "This paper describes the rationale behind the trial 'Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment (ACEI/ARB) of MINOCA patients' (MINOCA-BAT) and the need to improve the secondary preventive treatment of MINOCA patients. " 01/01/2021 - "This manuscript presents the rationale behind Randomized Evaluation of Beta Blocker and Angiotensin-converting enzyme inhibitors/Angiotensin Receptor Blocker Treatment (ACEI/ARB) for Post Infarct Angina in MINOCA patients-The MINOCA BAT post infarct angina sub study. " 01/01/2021 - "Selecting angiotensin converting enzyme inhibitor (ACEI) or angiotensin II type I receptor blocker (ARB) in patients diagnosed as acute myocardial infarction (AMI) with non-obstructive coronary arteries (MINOCA) is not established. " 01/01/2021 - "Comparative effect of angiotensin converting enzyme inhibitor versus angiotensin ii type i receptor blocker in acute myocardial infarction with non-obstructive coronary arteries; from the Korea Acute Myocardial Infarction Registry - National Institute of Health." 01/01/2021 - "Randomized evaluation of beta blocker and ACE-inhibitor/angiotensin receptor blocker treatment in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA-BAT): Rationale and design."
8.	Angiotensin Receptor AntagonistsIBA 01/01/2021 - "This paper describes the rationale behind the trial 'Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment (ACEI/ARB) of MINOCA patients' (MINOCA-BAT) and the need to improve the secondary preventive treatment of MINOCA patients. " 01/01/2021 - "This manuscript presents the rationale behind Randomized Evaluation of Beta Blocker and Angiotensin-converting enzyme inhibitors/Angiotensin Receptor Blocker Treatment (ACEI/ARB) for Post Infarct Angina in MINOCA patients-The MINOCA BAT post infarct angina sub study. " 01/01/2021 - "Randomized evaluation of beta blocker and ACE-inhibitor/angiotensin receptor blocker treatment in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA-BAT): Rationale and design." 01/01/2021 - "Randomized Evaluation of Beta Blocker and ACE-Inhibitor/Angiotensin Receptor Blocker Treatment for Post Infarct Angina in Patients With Myocardial Infarction With Non-obstructive Coronary Arteries: A MINOCA-BAT Sub Study Rationale and Design." 01/01/2021 - "We evaluated variability in discharge prescription of angiotensin-converting enzyme inhibitors / angiotensin receptor blockers (ACEI/ARB) and beta-blockers (BB) to MINOCA patients between hospitals to assess physician equipoise about secondary prevention. "
9.	Acetylcholine (Acetylcholine Chloride)FDA Link 10/01/2023 - "We here present three cases of MINOCA/INOCA that were evaluated using optical coherence tomography, coronary flow reserve, index of microcirculatory resistance, and acetylcholine provocative test. " 05/01/2021 - "White Clot Formation at Acetylcholine Testing: A Change of Heart in MINOCA?" 01/01/2021 - "MB was an independent predictor of positive acetylcholine test and MINOCA. " 01/01/2021 - "MB and a positive acetylcholine test coexisted more frequently in patients with MINOCA versus stable NOCAD. " 01/01/2021 - "This study aimed to assess the angiographic characteristics, feasibility and safety of the provocative test with acetylcholine (AChT), and the influence on further treatment and prognosis of Middle European patients in 5-year follow-up, especially focusing on those with a history of myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA). "
10.	Troponin T (Troponin T1)IBA 01/01/2021 - "Multivariable analysis showed that elevated levels of troponin-T and CK, ST-segment deviation on electrocardiography, reduced left ventricular ejection fraction, regional wall motion abnormalities, and performance of additional examination methods were independent predictors for finding the underlying MINOCA cause. " 01/01/2018 - "We therefore aimed to investigate the one-year prognostic value of high-sensitivity cardiac troponin T (hs-cTnT) levels in MINOCA in comparison to MI-CAD. " 01/01/2023 - "It is unknown whether the degree of high-sensitivity troponin T (hsTropT) elevation in patients with suspected myocardial infarction without obstructive coronary arteries (MINOCA) presentations can help predict the likelihood of an abnormal cardiac magnetic resonance (CMR) scan. " 01/01/2023 - "Troponin T Levels and When to Peek Using CMR in Patients With MINOCA." 01/01/2021 - "MINOCA patients with a confirmed diagnosis were younger compared to those with an indeterminate diagnosis (56.7 vs. 62.3 years, p = 0.007), had higher maximum troponin-T [238 ng/L vs. 69 ng/L, p < 0.001] and creatine kinase (CK) levels [212U/L vs. 152U/L, p = 0.007], and presented more frequently with electrocardiographic signs of ischaemia (71.0% vs. 47.1%, p = 0.002). "

Therapies and Procedures

1.	Therapeutics 11/15/2023 - "Nine studies with 27,731 MINOCA patients met inclusion criteria for evaluating the utility of medical therapy. " 11/15/2023 - "A literature search was also conducted for studies reporting on the association of medical therapy at risk of adverse outcomes in patients with MINOCA. " 12/02/2022 - "Of importance, the results derived from this trial may pave the way for a new pathophysiology-driven approach with cause-target therapies personalised for the mechanisms of MINOCA (ClinicalTrials.gov: NCT05122780)." 01/01/2022 - "Although the current observational studies do not show an obvious beneficial effect of antiplatelet therapy on MINOCA. " 01/01/2021 - "SUMMARY: While patients with MINOCA have an increased risk of serious cardiovascular events and death, whether conventional secondary preventive therapies are beneficial has not been assessed in randomized trials. "
2.	Secondary Prevention 12/01/2020 - "This study aimed to evaluate the associations between secondary prevention medications and outcomes in patients with MINOCA. " 04/18/2017 - "Clinical trials of secondary prevention treatment in MINOCA patients are lacking. " 01/01/2024 - "Although uncovering the pathogenesis of MINOCA might be essential for establishing an individualized treatment approach, significant knowledge gaps in terms of secondary prevention strategies for MINOCA focusing on the improvement of long-term prognosis remain to be overcome. " 03/01/2023 - "MINOCA patients had reduced mortality at long-term follow-up if prescribed secondary prevention medications (aHR 0.64, 95% CI 0.47-0.87, P = 0.004). " 03/01/2023 - "Less secondary prevention medications were prescribed at discharge for MINOCA than MIOCA. "
3.	Precision Medicine 11/02/2023 - "Precision medicine aims to introduce new diagnostic tools to assist in early diagnosis and further management of MINOCA. " 11/01/2022 - "Myocardial infarction with nonobstructive coronary arteries: the need for precision medicine." 01/01/2022 - "Editorial: MINOCA: Pathogenesis, Diagnosis, Clinical Management and Evolution Towards Precision Medicine." 06/01/2020 - "Through this process, it is possible to identify the cause of MINOCA, fundamental for targeting therapy on the disease mechanism, thus constituting a typical example of precision medicine." 12/02/2022 - "The PROMISE trial is a randomised, multicentre, prospective, superiority, phase IV trial that will include 180 MINOCA patients randomised 1:1 to a "precision-medicine approach", consisting of a comprehensive diagnostic workup and pharmacological treatment specific for the underlying cause, versus a "standard of care" approach, consisting of routine diagnostic workup and standard medical treatment for acute coronary syndrome. "
4.	Cardiac Rehabilitation 01/01/2020 - "Studies on the effect that exercise-based cardiac rehabilitation (CR) has on outcomes in MINOCA patients are lacking. " 01/01/2021 - "Though there was no difference in readmission and mortality between MINOCA and MI-CAD; use of secondary prevention medications and cardiac rehabilitation referral was low in MINOCA patients. " 01/01/2020 - "Effect of exercise-based cardiac rehabilitation on clinical outcomes in patients with myocardial infarction in the absence of obstructive coronary artery disease (MINOCA)."
5.	Patient Readmission 11/01/2023 - "The prevalence of MINOCA is estimated to range from approximately 6 to 10% among MI patients, and those with this condition have a poor prognosis, experiencing high rates of mortality, rehospitalization, and socioeconomic burden. " 01/01/2022 - "In univariate Cox regression analyses, NSTE-MINOCA showed an increased risk of long-term primary endpoint (HR 2.57, 95 CI%: 1.10-6.02) and CVS-related rehospitalization (HR 3.14, 95% CI: 1.16-8.48). " 01/01/2022 - "During median follow-up time of 24.5 months, STE-MINOCA group also demonstrated lower risks for primary endpoint and cardiovascular-related (CVS) rehospitalization. " 01/01/2021 - "Initially believed to be a benign condition, is now becoming clear that MINOCA is associated with a non-negligible risk of mortality, rehospitalization, disability and angina burden at follow-up, with high socioeconomic costs. " 01/01/2022 - "After adjusting for NT-proBNP and DAPT, NSTE-MINOCA remained an independent risk factor for CVS-related rehospitalization in long-term follow-up (HR 2.78, 95% CI: 1.03-7.49). "