CLINICAL PRACTICES APPLIED TO PATIENTS WITH MYOCARDIAL INFARCTION NON-OBSTRUCTION CORONARY ARTERIES (MINOCA)
DOI:
https://doi.org/10.36489/nursing.2023v26i300p9616-9624Keywords:
Myocardial infarction without coronary artery obstruction; Therapeutics; Treatment; clinical decision makingAbstract
Objective: To identify clinical practices with favorable results for patients diagnosed with acute myocardial infarction without coronary artery obstruction. Method: Integrative literature review using the National Library of Medicine and Virtual Health Library databases. Results: 87.5% of the studies found highlighted pharmacological strategies and of these, 62.5% cited the use of dual platelet antiaggregation as the most used, although no study showed benefits. Inhibitors of the renin-angiotensin-aldosterone system have shown benefits in three studies. 75% of the articles pointed out that this group of patients receive less preventive medication compared to patients with infarction due to coronary obstruction. Another six studies revealed variable clinical management of these patients. Conclusion: The use of renin-angiotensin-aldosterone system inhibitors should be considered as it is the only medication with proven reduction in mortality. Larger studies are needed to guide with more safety the management of myocardial infarction without coronary obstruction.
References
Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal DefinitionofMyocardialInfarction. J Am Coll Cardiol[Internet]. 2018 [cited 2022 Jun 25]; 72(18):2231-2264. Availablefrom: https://pubmed.ncbi.nlm.nih.gov/30153967
Lindahl B, Baron T, Albertucci M, Prati F. Myocardialinfarctionwith non-obstructivecoronaryarterydisease. EuroIntervention [internet]. 2021 [cited 2022 Jun 25]; 17:e875-e887. Availablefrom: https://eurointervention.pcronline.com/article/myocardial-infarction-with-non-obstructive-coronary-artery-disease
Matta AG, Nader V, Roncalli J. Management ofmyocardialinfarctionwithNonobstructiveCoronaryArteries (MINOCA): a subsetofacutecoronarysyndromepatients. Rev.Cardiovasc. [internet]. 2021 [cited 2022 Jun 25]; 22(3), 625–634; Availablefrom: https://www.imrpress.com/journal/RCM/22/3/10.31083/j.rcm2203073/htm
Asamoah K T. MyocardialInfarctionwithNonobstructiveCoronaryArteries: A DiagnosticChallenge. TH Open. [internet]. 2021 [cited 2022 Jun 25]; e195–e199; Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208841
Shamsi F, Hasan KY, Hashmani S, Jamal SF, Ellaham S. ReviewArticle—Clinical Overview ofMyocardialInfarctionWithoutObstructiveCoronaryArteryDisease (MINOCA). J Saudi Heart Assoc. [internet]. 2021 [cited 2022 Jun 25]; 33(1): 9–15. Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8051331
Hjort M, Lindahl B, Baron T, Jernberg T, Tornvall P, Eggers KM. Prognosis in relationto high-sensitivitycardiactroponin T levels in patientswithmyocardialinfarctionand non-obstructivecoronaryarteries. Am Heart J. [internet]. 2018 [cited 2022 Jun 25]. 200:60-66; Availablefrom: https://pubmed.ncbi.nlm.nih.gov/29898850/
Pelliccia F, Pasceri V, Niccoli G, Gaudio C, Crea F, Camici PG. PredictorsofMortality in MyocardialInfarctionandNonobstructedCoronaryArteries: A SystematicReviewand Meta-Regression. Am J Med. [internet]. 2019 [cited 2022 Jun 25]; 2019.05.048; Availablefrom: https://www.amjmed.com/article/S0002-9343(19)30530-3/fulltext
Eggers KM, Hjort M, Baron T, Jernberg T, Nordenskjöld AM, Tornvall P, et al. Morbidityand cause-specificmortality in first-time myocardialinfarctionwithnonobstructivecoronaryarteries. Jo I. M. [internet]. 2018 [cited 2022 Jun 25]; 12857; Availablefrom: https://onlinelibrary.wiley.com/doi/10.1111/joim.12857
Abdu FA, Mohammed AQ, Liu L, Xu Y, Che W. MyocardialInfarctionwithNonobstructiveCoronaryArteries (MINOCA): A ReviewoftheCurrent Position. Karger. [internet]. 2020 [cited 2022 Jun 25]; 145:543–552; Availablefrom: https://www.karger.com/Article/Pdf/509100
Serpytis R, Majauskiene E, Navickas P, Lizaitis M, Glaveckaite D, Rucinskas K, et al. RandomizedPilotTrialonOptimalTreatmentStrategy, MyocardialChanges, andPrognosisofPatientswithMyocardialInfardtionwithNonobstructiveCoronaryArteries (MINOCA). Am J Med. [internet]. 2021. [cited 2022 Jun 25]; 2021.08.023; Availablefrom: https://www.sciencedirect.com/science/article/abs/pii/S0002934321005866#preview-section-cited-by
Souza MT, Silva MD, Carvalho R, Revisão integrativa: o que é e como fazer. Einstein. [internet]. 2010. [cited 2022 Jun 18]. Availablefrom: https://www.scielo.br/j/eins/a/ZQTBkVJZqcWrTT34cXLjtBx/?lang=pt
Santos CM, Pimenta CA, Nobre MR. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Rev. Latino-Am. Enfermagem. [Internet]. 2007. [cited 2022 Jun 18]. Availablefrom: https://www.scielo.br/j/rlae/a/CfKNnz8mvSqVjZ37Z77pFsy/?lang=pt
Qualis/CAPES. Plataforma Sucupira. Disponível em: https://sucupira.capes.gov.br/sucupira/public/index.xhtml
Safdar B, Spatz ES, Dreyer RP, Beltrame JF, Lichtman JH, Spertus JÁ, et al. Presentation, Clinical Profile, andPrognosisof Young PatientsWithMyocardialInfarctionWithNonobstructiveCoronaryArteries (MINOCA): ResultsFromthe VIRGO Study. J Am Heart Assoc. [Internet]. 2018 [cited 2022 Nov 11]; 7(13): e009174; Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6064896
Paliosso P, Bergamaschi L, Saturi G, D´Angelo, EC, Magnani I, Toniolo S, et al. SecondaryPrevention Medical TherapyandOutcomes in PatientsWithMyocardialInfarctionWith Non-ObstructiveCoronaryArteryDisease. Front Pharmacol. [Internet] 2020. [cited 2022 Nov 23]; 10: 1606; Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7005107
Gasior P, Desperak A, Gierlotka M, Milewski K, Wita K, Kalarus Z, et al. ClinicalCharacteristics, Treatments, andOutcomesofpatientsqithMyocardialInfarctionwith Non-ObstructivecoronaryArteries (MINOCA): Resultsfrom a MulticenterNational Registry. J. Clin Med. [Internet]. 2020 [cited 2022 Nov 23]; 9(9):2779; Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564426
Sá F M, Carvalho RC, Santos L, Ruivo C, Antunes A, Belo A, et al. Dual antiplatelettherapy in myocardialinfarctionwith non-obstructivecoronaryarterydisease – insights from a nationwide registry. J.Rev.P.C. [Internet]. 2020 [cited 2022 Nov 23]. 2020.05.008; Availablefrom: https://www.sciencedirect.com/science/article/pii/S087025512030408X?via%3Dihub
Reynolds HR, Maehara A, Kwong RY, Sedlak T, Saw J, Smilowitz NR, et al. CoronaryOpticalCoherenceTomographyandCardiacMagneticResonanceImagingto Determine Underlying Causes ofMyocardialInfarctionWithNonobstructiveCoronaryArteries in Women. Circulation AHA. [Internet]. 2021 [cited 2022 Nov 23]; 143(7): 624–640.Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627695
Ahn JH, Hyun JY, Jeong MH, Kim JH, Hong YJ, Sim DS, et al. Comparativeeffectofangiotensinconvertingenzymeinhibitor versus angiotensin II type I receptor blocker in acutemyocardialinfarctionwith non-obstructivecoronaryarteries; fromtheKoreaAcuteMyocardialInfarction Registry—NationalInstituteof Health. Cardiol J. [Internet]. 2021 [cited 2022 Nov 23]; 28(5): 738–745 Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428933
Gao S, Xu H, Huang S, Yuan J, Yu M. Real-World Use ofClopidogrelandTicagrelor in PatientsWithMyocardialInfarctionWithNonobstructiveCoronaryArteries: PatientCharacteristicsandLong-TermOutcomes. Front Cardiovasc. Med. [Internet]. 2021 [cited 2022 Nov 23]. 8: 807494 Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8724121
Smilowitz NR, Dubner R, Hellkamp AS, Widmer RJ, Reynolds HR. Variabilityofdischarge medical therapy for secondarypreventionamongpatientswithmyocardialinfarctionwith non-obstructivecoronaryarteries (MINOCA) in the United States. Journal P One. [Internet]. 2021 [cited 2022 Nov 23]; e0255462 Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328325
Amores N, Salvador P. Utilidaddelultrasonidointracoronarioenel diagnóstico de diseccióncoronaria espontânea. Arch. Cardiol. Méx. [Internet]. 2019 [cited 2022 Nov 23]. 19000013; Availablefrom: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1405-99402019000100082
