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Myocardial Infarction with Non-Obstructive Coronary Arteries: Contemporary Diagnostic and Management Approaches

https://doi.org/10.20996/1819-6446-2019-15-6-881-891

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Abstract

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is diagnosed in the absence of anatomically significant stenoses (<50% of lumen diameter) on coronary angiography and characterized by heterogeneity of etiologic factors. Recently, the mechanisms of MINOCA as well as the performance of diagnostic algorithms and therapeutic strategies have been extensively studied. The purpose of this review is to reflect the current concepts regarding the etiology and pathogenesis of MINOCA, diagnostic work-up methods and individualized treatment approaches. The article covers contemporary epidemiologic data, demographic and clinical patients’ characteristics and principal causes of MINOCA. We discuss aspects of disease definition and classification of related conditions involving troponin increase in the presence of normal coronary arteries. The importance of management strategy personalization for individual patients is stressed alongside stratification of risks of recurrent cardiovascular events. This review reflects key points from international consensus statements published by leading experts and suggests promising directions for future research.

About the Authors

T. H. Hoang
Peoples Friendship University of Russia (RUDN University)
Russian Federation

Truong H. Hoang – MD, Postgraduate Student, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev

Miklukho-Maklaya ul. 6, Moscow, 117198



P. V. Lazarev
Peoples Friendship University of Russia (RUDN University)
Russian Federation

Pavel V. Lazarev – MD, PhD, Associate Professor, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev

Miklukho-Maklaya ul. 6, Moscow, 117198



V. V. Maiskov
Peoples Friendship University of Russia (RUDN University); Pirogov Russian National Research Medical University; Vinogradov City Clinical Hospital
Russian Federation

Victor V. Maiskov – MD, PhD, Associate Professor, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev, RUDN University; Associate Professor, Chair of Endovascular Surgery, Pirogov Russian National Research Medical University; Head of the Department of Endovascular Surgery, Vinogradov City Clinical Hospital

Miklukho-Maklaya ul. 6, Moscow, 117198, 

Ostrovitianova ul. 1, Moscow, 117997, 

Vavilova ul. 61, Moscow, 117292



A. I. Meray
Peoples Friendship University of Russia (RUDN University); Vinogradov City Clinical Hospital
Russian Federation

Imad A. Meray – MD, PhD, Associate Professor, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician Moiseev, RUDN University; Head of the Intensive Care Unit, Vinogradov City Clinical Hospital

Miklukho-Maklaya ul. 6, Moscow, 117198, 

Vavilova ul. 61, Moscow, 117292



Zh. D. Kobalava
Peoples Friendship University of Russia (RUDN University)
Russian Federation

Zhanna D. Kobalava – MD, PhD, Professor, Head of Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev

Miklukho-Maklaya ul. 6, Moscow, 117198



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For citation:


Hoang T.H., Lazarev P.V., Maiskov V.V., Meray A.I., Kobalava Z.D. Myocardial Infarction with Non-Obstructive Coronary Arteries: Contemporary Diagnostic and Management Approaches. Rational Pharmacotherapy in Cardiology. 2019;15(6):881-891. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-6-881-891

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