Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): Focus on Coronary Microvascular Dysfunction and Genetic Susceptibility

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 May 27

PMID 37240691

Authors

Paolo Severino

Andrea DAmato

Silvia Prosperi

Vincenzo Myftari

Lorenzo Colombo

Elisa Tomarelli

Alice Piccialuti

Gianluca Di Pietro

Lucia Ilaria Birtolo

Viviana Maestrini

Roberto Badagliacca

Gennaro Sardella

Francesco Fedele

Carmine Dario Vizza

Massimo Mancone

Affiliations

Soon will be listed here.

Abstract

Among the most common causes of death worldwide, ischemic heart disease (IHD) is recognized to rank first. Even if atherosclerotic disease of the epicardial arteries is known as the leading cause of IHD, the presence of myocardial infarction with non-obstructive coronary artery disease (MINOCA) is increasingly recognized. Notwithstanding the increasing interest, MINOCA remains a puzzling clinical entity that can be classified by distinguishing different underlying mechanisms, which can be divided into atherosclerotic and non-atherosclerotic. In particular, coronary microvascular dysfunction (CMD), classifiable in non-atherosclerotic mechanisms, is a leading factor for the pathophysiology and prognosis of patients with MINOCA. Genetic susceptibility may have a role in primum movens in CMD. However, few results have been obtained for understanding the genetic mechanisms underlying CMD. Future studies are essential in order to find a deeper understanding of the role of multiple genetic variants in the genesis of microcirculation dysfunction. Progress in research would allow early identification of high-risk patients and the development of pharmacological, patient-tailored strategies. The aim of this review is to revise the pathophysiology and underlying mechanisms of MINOCA, focusing on CMD and actual knowledge about genetic predisposition to it.

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