PericOronary INflammaTion in Non-Obstructive Coronary Artery Disease
Status:
Recruiting
Trial end date:
2024-12-01
Target enrollment:
Participant gender:
Summary
Among patients with ischemic heart disease who are referred for coronary angiography, a
substantial proportion have non-obstructive coronary artery disease (CAD). Myocardial
infarction (MI) with non-obstructive coronary artery disease (MINOCA) accounts for 5-20% of
patients with MI and preferentially affects women. MINOCA pathogenesis is varied and may
include atherosclerotic plaque rupture, plaque erosion with thrombosis, vasospasm,
embolization, dissection or a combination of mechanisms. Other patients may have clinically
unrecognized myocarditis, or takotsubo syndrome masquerading as MI. Among patients referred
for coronary angiography for the evaluation of stable ischemic heart disease, non-obstructive
CAD is present in up to ~30% of men and ~60% of women. Stable ischemia with non-obstructive
coronary arteries (INOCA) may be due to coronary microvascular dysfunction in up to 40% of
these patients. Our understanding of mechanisms of MINOCA and INOCA remain incomplete.
Coronary inflammation has been hypothesized as a potential mechanism contributing to coronary
spasm in MINOCA and microvascular disease in INOCA.