Cardiovascular diseases, particularly
myocardial infarction (MI), are a significant cause of mortality globally. Traditional MIs are commonly linked to substantial coronary artery blockage. However, a distinct subset of patients experience MI with non-obstructive coronary arteries, known as
MINOCA. Imaging techniques, such as invasive coronary angiograms, are employed to diagnose MI or assess predisposition to one. Coronary angiograms help visualize vessel blockages; however, these blockages are absent in
MINOCA cases, posing a diagnostic challenge.
Precision medicine aims to introduce new diagnostic tools to assist in early diagnosis and further management of
MINOCA. As
percutaneous coronary intervention (PCI) does not benefit
MINOCA patients, medical management tailored to the specific pathophysiological mechanism of
MINOCA is employed. 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. On the other hand, if
coronary artery spasm is identified as the primary cause, essential intervention involves the use of
calcium channel blockers. This approach has been previously utilized in patients with vasospastic angina and could be utilized in
MINOCA, although research specific to
MINOCA is ongoing. Therefore, the handling of
MINOCA underscores the necessity for a tailored therapeutic strategy that corresponds to the underlying physiological mechanism responsible for the patient's clinical symptoms. Ongoing research initiatives are directed at expanding the availability of these treatments, uncovering new
biomarkers, creating advanced diagnostic instruments, and establishing a more individualized approach for managing
MINOCA patients.