MINOCA Today – Are We There Yet?

Abstract

In the last few years, the concept of myocardial infarction with non-obstructive coronary artery disease (MINOCA) has been one of the emerging hot topics in the field of cardiovascular medicine. The most recent studies in this field, focused on multiple approaches including invasive and noninvasive imaging techniques or various laboratory biomarkers, did not succeed to completely elucidate this frequent cause of acute myocardial infarction (AMI). The consensus papers published by the working groups of the European Society of Cardiology (ESC) have established the diagnostic criteria for MINOCA, defined as the absence of stenosis higher than 50% in an epicardial coronary artery at coronary angiography, in the clinical context of an AMI. At the same time, the Fourth Universal Definition of Myocardial Infarction, published in 2018, acknowledges this condition as a separate entity.1,2