Role of Personalized Medicine in Myocardial Infarction With Nonobstructive Coronary Artery Disease (MINOCA): An Updated Review

Abstract

Cardiovascular diseases, notably myocardial infarction (MI), contribute significantly to global mortality. While traditional MIs are often associated with notable coronary artery blockages, a subgroup experiences MI without such blockages, termed myocardial infarction with nonobstructive coronary arteries (MINOCA). Current diagnostic methods, like invasive coronary angiograms, are inadequate in diagnosing MINOCA due to the absence of visible vessel blockages. Personalized medicine endeavors to introduce novel diagnostic tools for early identification and tailored management of MINOCA. Unlike percutaneous coronary intervention, which lacks efficacy in MINOCA, personalized medical management aligned with the specific underlying pathophysiological cause is essential. Treatments may include statins, agents modulating the renin-angiotensin system, and antiplatelet therapies if linked to plaque disruption. At the same time, calcium channel blockers may be pivotal if coronary artery spasm is the primary cause. Research is ongoing to refine tailored therapies and discover new biomarkers, highlighting the crucial need for individualized approaches in managing MINOCA.