![]() ![]() The management of patients with MINOCA will vary depending on the underlying cause, for which an extensive evaluation should be undertaken in all patients. Accordingly, MINOCA is initially considered at the time of angiography as a working diagnosis until further assessment excludes other possible causes for troponin elevation. The term MINC 7 or MINCA 8 (myocardial infarction with normal coronary arteries) was initially coined to describe these patients and later evolved to MINOCA 9 to encompass patients with evidence of atherosclerosis that is not considered sufficiently severe to compromise myocardial blood flow. This figure was subsequently confirmed in several large AMI registries 5 and in a large meta-analysis in which 6% of AMIs occurred in the absence of obstructive CAD. 1, 2 The pioneering angiographic studies by DeWood et al 3, 4 reported a prevalence of nonobstructive coronary artery disease (CAD) in ≈5% of patients with acute myocardial infarction (AMI). Myocardial infarction in the absence of obstructive coronary artery disease (MINOCA) was first documented >75 years ago when autopsy reports detailed myocardial necrosis in the absence of significant coronary atherosclerosis. ![]() Customer Service and Ordering Information.Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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