The Role of Antiplatelet Therapy in Patients With MINOCA

Ortega‐Paz, Luis; Galli, Mattía; Capodanno, Davide; Brugaletta, Salvatore; Angiolillo, Dominick J.

doi:10.3389/fcvm.2021.821297

Cited by 10 publications

(4 citation statements)

References 62 publications

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“…In cases of refractory variant angina, nitrates can be added to calcium channel antagonists, which enables vascular smooth muscle relaxation through nitric oxide reduction ( 98 ). Coronary embolism or thrombosis are treated with antithrombotic agents and targeted therapies for underlying thrombophilia ( 99 ).…”

Section: Treatmentmentioning

confidence: 99%

Myocardial infarction with non-obstructive coronary arteries (MINOCA)

Yildiz

Ashokprabhu

Shewale

et al. 2022

Front. Cardiovasc. Med.

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Myocardial infarction with non-obstructive coronary arteries (MINOCA) is evident in up to 15% of all acute myocardial infarctions (AMI) and disproportionally affects females. Despite younger age, female predominance, and fewer cardiovascular risk factors, MINOCA patients have a worse prognosis than patients without cardiovascular disease and a similar prognosis compared to patients with MI and obstructive coronary artery disease (CAD). MINOCA is a syndrome with a broad differential diagnosis that includes both ischemic [coronary artery plaque disruption, coronary vasospasm, coronary microvascular dysfunction, spontaneous coronary artery dissection (SCAD), and coronary embolism/thrombosis] and non-ischemic mechanisms (Takotsubo cardiomyopathy, myocarditis, and non-ischemic cardiomyopathy)—the latter called MINOCA mimickers. Therefore, a standardized approach that includes multimodality imaging, such as coronary intravascular imaging, cardiac magnetic resonance, and in selected cases, coronary reactivity testing, including provocation testing for coronary vasospasm, is necessary to determine underlying etiology and direct treatment. Herein, we review the prevalence, characteristics, prognosis, diagnosis, and treatment of MINOCA -a syndrome often overlooked.

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Section: Treatmentmentioning

confidence: 99%

Myocardial infarction with non-obstructive coronary arteries (MINOCA)

Yildiz

Ashokprabhu

Shewale

et al. 2022

Front. Cardiovasc. Med.

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“…Other authors instead have suggested that coronary spasm associated with acute myocardial ischemia causes platelet activation and aggregation in the coronary circulation and may aggravate symptoms and outcomes 10 . For this reason and also because atherosclerotic coronary disease had not been entirely ruled out, we administered single antiplatelet drug (SAPT) 11 …”

Section: Discussionmentioning

confidence: 99%

Naphazoline abuse: a rare case of myocardial infarction with nonobstructive coronary arteries

Galasso,

Cavallotti,

Giannattasio

et al. 2024

Journal of Cardiovascular Medicine

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Nasal vasoconstrictors are some of the most widely used over-the-counter drugs, considered by many consumers as relatively safe with few significant adverse effects. At recommended dosage, the drug produces local vasoconstriction in nasal mucous membranes. However, the use of such drugs has been linked to cardiovascular adverse effects, including hypertension, arrhythmias, prolongation of the QT interval, and angina pectoris. 1 The various cardiovascular adverse effects may occur with both oral and nasal administration and after a single dose or prolonged treatment, without dose-effect and independently of vascular status and age. 2 Although the effects of ephedrine and pseudoephedrine have been widely studied, the effects of naphazoline are less well known. We describe the case of a previously healthy man who experienced a MINOCA (myocardial infarction with nonobstructive coronary arteries) after abuse of recommended dose of naphazoline. To our knowledge, this is the first time that a strict temporal relation between the occurrence of MINOCA and topical naphazoline abuse is being described.

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“…Dual antiplatelet therapy was not associated with a lower MACE rate at one-year follow-up. The therapeutic role of antiplatelets in coronary plaque disruption is more well-defined compared with coronary vasospasm [ 14 ], in which calcium channel blockers are the mainstay of treatment [ 9 ]. No randomized trial data are available to guide therapeutic recommendations or define optimal medical management for MINOCA patients.…”

Section: Managementmentioning

confidence: 99%