OCT Findings in MINOCA.
Krzysztof BryniarskiPaweł M GąsiorJacek LegutkoDawid MakowiczAnna KedzioraPiotr SzolcLeszek BryniarskiPaweł KleczyńskiIk-Kyung JangPublished in: Journal of clinical medicine (2021)
Myocardial infarction with non-obstructive coronary artery disease (MINOCA) is a working diagnosis for patients presenting with acute myocardial infarction without obstructive coronary artery disease on coronary angiography. It is a heterogenous entity with a number of possible etiologies that can be determined through the use of appropriate diagnostic algorithms. Common causes of a MINOCA may include plaque disruption, spontaneous coronary artery dissection, coronary artery spasm, and coronary thromboembolism. Optical coherence tomography (OCT) is an intravascular imaging modality which allows the differentiation of coronary tissue morphological characteristics including the identification of thin cap fibroatheroma and the differentiation between plaque rupture or erosion, due to its high resolution. In this narrative review we will discuss the role of OCT in patients presenting with MINOCA. In this group of patients OCT has been shown to reveal abnormal findings in almost half of the cases. Moreover, combining OCT with cardiac magnetic resonance (CMR) was shown to allow the identification of most of the underlying mechanisms of MINOCA. Hence, it is recommended that both OCT and CMR can be used in patients with a working diagnosis of MINOCA. Well-designed prospective studies are needed in order to gain a better understanding of this condition and to provide optimal management while reducing morbidity and mortality in that subset patients.
Keyphrases
- coronary artery disease
- coronary artery
- optical coherence tomography
- diabetic retinopathy
- end stage renal disease
- high resolution
- magnetic resonance
- acute myocardial infarction
- percutaneous coronary intervention
- chronic kidney disease
- pulmonary artery
- ejection fraction
- left ventricular
- optic nerve
- coronary artery bypass grafting
- peritoneal dialysis
- cardiovascular events
- machine learning
- aortic stenosis
- heart failure
- prognostic factors
- magnetic resonance imaging
- dna methylation
- patient reported outcomes
- atrial fibrillation
- contrast enhanced