ESC working group position paper on myocardial infarction with non-obstructive coronary arteries

Stefan Agewall, John F. Beltrame, Harmony R. Reynolds, Alexander Niessner, Giuseppe Rosano, Alida L P Caforio, Raffaele De Caterina, Marco Zimarino, Marco Roffi, Keld Kjeldsen, Dan Atar, Juan Carlos Kaski, Udo Sechtem, Per Tornvall

Research output: Contribution to journalReview article

Abstract

Myocardial infarction with non-obstructive coronary arteries is a heterogeneous entity with a prevalence of 1?13% of all patients with a clinical diagnosis of AMI. There are several potential aetiologies that should be elucidated by a commonly agreed diagnostic algorithm, proposed herein. Rational treatment follows from an aetiologic diagnosis, since therapy that may be appropriate for one cause (e.g. anticoagulation for thromboembolism or calcium channel blockers for vasospasm) will not be appropriate for all MINOCA patients. In MINOCA patients without an obvious aetiology after initial evaluation including echocardiography, we recommend a routine examination with CMR imaging. Multi-centre clinical trials of diagnostic and therapeutic strategies are needed. These results will have great impact on both treatment and prognosis of these patients.

Original languageEnglish
Pages (from-to)143-153
Number of pages11
JournalEuropean Heart Journal
Volume38
Issue number3
DOIs
Publication statusPublished - Jan 1 2017

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Agewall, S., Beltrame, J. F., Reynolds, H. R., Niessner, A., Rosano, G., Caforio, A. L. P., Caterina, R. D., Zimarino, M., Roffi, M., Kjeldsen, K., Atar, D., Kaski, J. C., Sechtem, U., & Tornvall, P. (2017). ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. European Heart Journal, 38(3), 143-153. https://doi.org/10.1093/eurheartj/ehw149