Sex-related MINOCA and MIOCA differences. Several international guidelines recommend invasive treatment after diagnosing an acute coronary syndrome (ACS). The first studies that described acute myocardial infarction (AMI) without obstructive epicardial coronary disease reported a 10% incidence rate. Based on this significant prevalence, it was recommended that this diagnosis be classified as MINOCA for patients who…
One Year Prognosis of Atherosclerotic vs. Non-Atherosclerotic Lesions in MINOCA Patients
The use of intravascular imaging helps improve diagnosis in situations where a conventional coronary angiography might not be conclusive. That is the case of patients with myocardial infarction with non-obstructive coronary artery lesions (MINOCA). The largest MINOCA cohort reported so far has shown 5%-7% prevalence. This pathology, initially considered benign, presents a remote mortality rate…
Safety of Acetylcholine in the Cath Lab
The concepts of ischemia with non-obstructive coronary artery disease (INOCA) and myocardial infarction with non-obstructive coronary artery disease (MINOCA) have been established, widely spread, accepted, and included in the different guidelines that support our clinical practice. Among INOCA and MINOCA we find vasospastic angina (VSA) caused by epicardial vessel spasms and angina caused by microvascular…
AHA 2020 | In Most Cases, Imaging Can Determine What Causes MINOCA
Intravascular imaging with coronary optical coherence tomography (OCT) and magnetic resonance imaging allow for the identification of the cause of heart attack in 85% of women without coronary obstructions in angiography. Myocardial infarction with non-obstructive coronary arteries (MINOCA) affects women disproportionately and we have considered these events as “false positives” for far too long. The…