Current Overview of Myocardial Infarction with Non-Obstructive Coronary Arteries

Abstract

The concept and diagnosis of MINOCA Recent advancements in the medical field have significantly improved the diagnosis and treatment of ischemic heart disease (IHD). These advancements include therapeutic interventions targeting primary and secondary prevention, particularly antiplatelet-based antithrombotic therapy. Furthermore, management of lifestyle-associated diseases, including dyslipidemia, diabetes, and hypertension, has been emphasized. The introduction of high-sensitivity cardiac troponin measurement systems has enhanced detection of minor myocardial injuries. In addition, the accuracy of coronary computed tomography (CT) angiography has substantially improved. Other notable technological innovations in cardiac catheterization procedures, such as coronary angiography (CAG) and percutaneous coronary intervention (PCI), have also been developed. In the context of acute myocardial infarction (AMI), improved medical access and healthcare infrastructure have enabled rapid CAG and PCI to be performed in most medical institutions. This has led to significant improvements in the outcomes of AMI treatment. Recently, myocardial infarction without coronary artery obstruction (known as myocardial infarction with non-obstructive coronary arteries [MINOCA]) has gained recognition. This recognition came with the establishment of a medical system that allowed emergency CAG and reperfusion therapy for myocardial infarction with coronary artery disease (MI-CAD). Consequently, challenges in the diagnosis and treatment of MINOCA have arisen.