References

rpcardio

Rational Pharmacotherapy in Cardiology

Рациональная Фармакотерапия в Кардиологии

1819-64462225-3653

«SILICEA-POLIGRAF» LLC

10.20996/1819-6446-2019-15-6-881-891

rpcardio-2081

Research Article

POINT OF VIEW

ТОЧКА ЗРЕНИЯ

Myocardial Infarction with Non-Obstructive Coronary Arteries: Contemporary Diagnostic and Management Approaches

Инфаркт миокарда без обструкции коронарных артерий: современные подходы к диагностике и лечению

Хоанг

Ч. Х.

Hoang

T. H.

Хоанг Хюй Чыонг – аспирант, кафедра внутренних болезней с курсом кардиологии и функциональной диагностики им. академика В.С. Моисеева

117198, Москва, ул. Миклухо-Маклая, 6

Truong H. Hoang – MD, Postgraduate Student, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev

Miklukho-Maklaya ul. 6, Moscow, 117198

Лазарев

П. В.

Lazarev

P. V.

Лазарев Павел Валерьевич – кандидат медицинских наук, доцент, кафедра внутренних болезней с курсом кардиологии и функциональной диагностики им. академика В.С. Моисеева

117198, Москва, ул. Миклухо-Маклая, 6

Pavel V. Lazarev – MD, PhD, Associate Professor, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev

Miklukho-Maklaya ul. 6, Moscow, 117198

spaceman665@gmail.com

Майсков

В. В.

Maiskov

V. V.

Майсков Виктор Викторович кандидат медицинских наук, доцент, кафедра внутренних болезней с курсом кардиологии и функциональной диагностики им. академика В.С. Моисеева, РУДН; доцент, кафедра рентгенэндоваскулярных методов диагностики и лечения, РНИМУ; заведующий отделением рентгенохирургических методов диагностики и лечения, ГКБ им. В.В. Виноградова

117198, Москва, ул. Миклухо-Маклая, 6,

117997, Москва, ул. Островитянова, 1,

117292, Москва, ул. Вавилова, 61

Victor V. Maiskov – MD, PhD, Associate Professor, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev, RUDN University; Associate Professor, Chair of Endovascular Surgery, Pirogov Russian National Research Medical University; Head of the Department of Endovascular Surgery, Vinogradov City Clinical Hospital

Miklukho-Maklaya ul. 6, Moscow, 117198,

Ostrovitianova ul. 1, Moscow, 117997,

Vavilova ul. 61, Moscow, 117292

Мерай

И. А.

Meray

A. I.

Мерай Имад Ахмадович – кандидат медицинских наук, доцент, кафедра внутренних болезней с курсом кардиологии и функциональной диагностики им. академика В.С. Моисеева, РУДН; заведующий отделением кардиореанимации, ГКБ им. В.В. Виноградова

117198, Москва, ул. Миклухо-Маклая, 6,

117292, Москва, ул. Вавилова, 61

Imad A. Meray – MD, PhD, Associate Professor, Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician Moiseev, RUDN University; Head of the Intensive Care Unit, Vinogradov City Clinical Hospital

Miklukho-Maklaya ul. 6, Moscow, 117198,

Vavilova ul. 61, Moscow, 117292

Кобалава

Ж. Д.

Kobalava

Zh. D.

Кобалава Жанна Давидовна – доктор медицинских наук, профессор, зав. кафедрой внутренних болезней с курсом кардиологии и функциональной диагностики им. академика В.С. Моисеева

117198, Москва, ул. Миклухо-Маклая, 6

Zhanna D. Kobalava – MD, PhD, Professor, Head of Chair of Internal Medicine with the Subspecialty of Cardiology and Functional Diagnostics named after Academician V.S. Moiseev

Miklukho-Maklaya ul. 6, Moscow, 117198

Российский университет дружбы народовРоссияPeoples Friendship University of Russia (RUDN University)Russian Federation

Российский университет дружбы народов; Российский национальный исследовательский медицинский университет им. Н. И. Пирогова; Городская Клиническая Больница им. В.В. ВиноградоваРоссияPeoples Friendship University of Russia (RUDN University); Pirogov Russian National Research Medical University; Vinogradov City Clinical HospitalRussian Federation

Российский университет дружбы народов; Городская Клиническая Больница им. В.В. ВиноградоваРоссияPeoples Friendship University of Russia (RUDN University); Vinogradov City Clinical HospitalRussian Federation

2019

03012020

156881891

2020

Хоанг Ч.Х., Лазарев П.В., Майсков В.В., Мерай И.А., Кобалава Ж.Д.

Hoang T.H., Lazarev P.V., Maiskov V.V., Meray A.I., Kobalava Z.D.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.rpcardio.online/jour/article/view/2081

Myocardial infarction with non-obstructive coronary arteries (MINOCA) is diagnosed in the absence of anatomically significant stenoses (<50% of lumen diameter) on coronary angiography and characterized by heterogeneity of etiologic factors. Recently, the mechanisms of MINOCA as well as the performance of diagnostic algorithms and therapeutic strategies have been extensively studied. The purpose of this review is to reflect the current concepts regarding the etiology and pathogenesis of MINOCA, diagnostic work-up methods and individualized treatment approaches. The article covers contemporary epidemiologic data, demographic and clinical patients’ characteristics and principal causes of MINOCA. We discuss aspects of disease definition and classification of related conditions involving troponin increase in the presence of normal coronary arteries. The importance of management strategy personalization for individual patients is stressed alongside stratification of risks of recurrent cardiovascular events. This review reflects key points from international consensus statements published by leading experts and suggests promising directions for future research.

Инфаркт миокарда без обструкции коронарных артерий (ИМбОКА) диагностируется при коронарной ангиографии в случае отсутствия анатомически значимых стенозов (<50% cужения просвета) и характеризуется гетерогенностью этиологических факторов. В последнее время предприняты многочисленные попытки изучения механизмов ИМбОКА, а также исследования, направленные на совершенствование диагностических алгоритмов и терапевтических стратегий. Цель настоящего обзора состоит в том, чтобы отразить современные представления об этиологии и патогенезе ИМбОКА, методах обследования пациентов и дифференцированном подходе к лечению. В статье освещены актуальные эпидемиологические данные, особенности популяции пациентов с данным диагнозом, подробно рассмотрены его основные причины. Затронуты вопросы определения ИМбОКА, проблемы классификации других состояний, сопровождающихся повышением тропонина при отсутствии изменений в коронарных артериях. Подчеркивается важность индивидуализации лечебной тактики для отдельных пациентов, стратификации риска повторных сердечно-сосудистых событий. В обзоре приведены основные положения международных согласительных документов, опубликованных ведущими экспертами по проблеме, также обозначены перспективные направления дальнейших исследований.

острый коронарный синдромкоронарная ангиографияинфаркт миокарда без обструкции коронарных артерийатеротромбозкоронарный вазоспазминфаркт миокарда второго типа

acute coronary syndromecoronary angiographymyocardial infarction with non-obstructive coronary arteriesatherothrombosiscoronary vasospasmtype 2 myocardial infarction

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The authors declare that there are no conflicts of interest present.